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General NPI Number Information
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NPI Number | 1144987074
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Entity Type | Organization
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Legal Business Name | K'NAI BEAUTY SUPPLY & SALON LLC
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Dates
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Enumeration Date | 11/28/2021
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Last Update Date | 11/28/2021
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Provider Practice Location Address
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Address Line | 1254 US 31W BYP
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City | BOWLING GREEN
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State | KY
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Zip | 42101-2577
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Country | US
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Telephone | 270-938-5354
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 WOODHURST ST
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3316
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Country | US
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Telephone | 270-777-6321
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMBER JEFFERSON
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Credential |
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Telephone | 270-777-6321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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