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General NPI Number Information
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NPI Number | 1487543575
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Entity Type | Organization
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Legal Business Name | BODY & SOUL HAIR RESTORATION, SALON AND SPA
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 6115 E COLFAX AVE
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City | DENVER
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State | CO
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Zip | 80220-1512
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Country | US
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Telephone | 303-388-3339
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Fax |
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Provider Business Mailing Address
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Address Line | 3580 HOLLY ST
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City | DENVER
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State | CO
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Zip | 80207-1210
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Country | US
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Telephone | 303-388-3339
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALICIA YVETTE BRYANT-MAYES
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Credential |
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Telephone | 720-252-5199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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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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