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General NPI Number Information
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NPI Number | 1265101919
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Entity Type | Organization
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Legal Business Name | SELA STYLEZ HAIR LLC.
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 2005 OSSABAW DR
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City | AUGUSTA
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State | GA
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Zip | 30906-3351
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Country | US
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Telephone | 706-828-1660
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Fax |
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Provider Business Mailing Address
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Address Line | 2005 OSSABAW DR
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City | AUGUSTA
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State | GA
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Zip | 30906-3351
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Country | US
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Telephone | 706-828-1660
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Fax |
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Authorized Official
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Title or Position | HAIR REPLACEMENT SPECIALIST
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Name | SERENA OSBORNE
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Credential |
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Telephone | 678-306-6339
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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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Taxonomy #2
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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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