Healthcare Provider Details

I. General information

NPI: 1538986823
Provider Name (Legal Business Name): SKIN PERFECT AESTHETICS AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 HERITAGE PARK DR STE 302
MURFREESBORO TN
37129-0505
US

IV. Provider business mailing address

151 HERITAGE PARK DR STE 302
MURFREESBORO TN
37129-0505
US

V. Phone/Fax

Practice location:
  • Phone: 615-801-2012
  • Fax:
Mailing address:
  • Phone: 615-801-2012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLA TRAIL
Title or Position: OWNER
Credential: NP
Phone: 931-273-8099