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General NPI Number Information
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NPI Number | 1548659600
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Entity Type | Organization
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Legal Business Name | STILL YOU HAIR REPLACEMENTS, LLC
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Dates
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Enumeration Date | 01/13/2015
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Last Update Date | 01/13/2015
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Provider Practice Location Address
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Address Line | 8111 CREEDMOOR RD
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City | RALEIGH
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State | NC
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Zip | 27613
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Country | US
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Telephone | 919-623-4388
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Fax |
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Provider Business Mailing Address
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Address Line | 213 DANESWAY DR.
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NON-SURGICAL-HAIR REPLACEMENT
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Name | ROSZETTA PRINGLE
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Credential |
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Telephone | 919-623-4388
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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 | C26279
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License Number State | NC
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