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General NPI Number Information
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NPI Number | 1477481869
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Entity Type | Organization
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Legal Business Name | DIVINE CROWN HAIR LOSS SOLUTION
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 2280 S CHURCH ST
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City | BURLINGTON
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State | NC
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Zip | 27215-5396
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Country | US
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Telephone | 336-213-8385
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Fax |
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Provider Business Mailing Address
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Address Line | 2280 S CHURCH ST
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City | BURLINGTON
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State | NC
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Zip | 27215-5396
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Country | US
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Telephone | 336-213-8385
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Fax |
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Authorized Official
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Title or Position | CERTIFCRANIAL PROTHESIS SPECIALIST
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Name | MS. STEPHANIE DENISE MORROW
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Credential | CRANIAL PROTHESIS SP
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Telephone | 336-213-8385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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