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General NPI Number Information
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NPI Number | 1386418002
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Entity Type | Organization
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Legal Business Name | INDULGENCE COLLECTION HAIR LLC
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 6605 TRANSON CT
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City | WHITSETT
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State | NC
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Zip | 27377-8767
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Country | US
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Telephone | 191-997-3936
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Fax |
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Provider Business Mailing Address
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Address Line | 6605 TRANSON CT
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City | WHITSETT
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State | NC
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Zip | 27377-8767
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Country | US
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Telephone | 191-997-3936
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEANGELECIA SHAUNTRICE MAYES
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Credential |
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Telephone | 919-973-9367
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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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