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General NPI Number Information
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NPI Number | 1174768162
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Entity Type | Organization
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Legal Business Name | COLOURS BEAUTY, INC
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Dates
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Enumeration Date | 12/05/2008
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Last Update Date | 12/05/2008
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Provider Practice Location Address
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Address Line | 728 BELMONT ST
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City | BROCKTON
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State | MA
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Zip | 02301-5602
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Country | US
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Telephone | 508-583-5838
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Fax | 508-408-0266
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Provider Business Mailing Address
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Address Line | 728 BELMONT ST
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City | BROCKTON
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State | MA
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Zip | 02301-5602
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Country | US
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Telephone | 508-583-5838
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Fax | 508-408-0266
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PETER KONG
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Credential |
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Telephone | 617-817-9370
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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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