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General NPI Number Information
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NPI Number | 1184382970
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Entity Type | Organization
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Legal Business Name | THE B. DAVIS HAIR CARE SALON INC
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 5401 S EAST ST STE 107
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-2076
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Country | US
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Telephone | 463-224-7952
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Fax | 317-757-6101
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Provider Business Mailing Address
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Address Line | 5401 S EAST ST STE 107
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-2076
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Country | US
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Telephone | 463-224-7952
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Fax | 317-757-6101
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Authorized Official
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Title or Position | OWNER
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Name | MS. BRANDI GENETTE SPENCER
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Credential | HAIR LOSS SPECIALIST
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Telephone | 463-224-7952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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