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General NPI Number Information
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NPI Number | 1154298305
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Entity Type | Organization
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Legal Business Name | KEZIAH HAIR EXTENSIONS
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 18 HUNT CLIFF POINT
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City | VILLA RICA
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State | GA
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Zip | 30180
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Country | US
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Telephone | 800-484-4435
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Fax |
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Provider Business Mailing Address
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Address Line | 3780 OLD NORCROSS RD STE 103
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City | DULUTH
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State | GA
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Zip | 30096-1762
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, CEO
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Name | KEISHA CUMBER
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Credential |
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Telephone | 800-484-4435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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