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General NPI Number Information
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NPI Number | 1609701390
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Entity Type | Organization
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Legal Business Name | DIVA SALON AND SPA LLC
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 501 ROCHESTER HWY STE A1
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City | SENECA
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State | SC
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Zip | 29672-2463
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Country | US
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Telephone | 864-614-1227
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Fax | 864-210-5209
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Provider Business Mailing Address
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Address Line | 204 ROANOKE WAY
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City | GREENVILLE
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State | SC
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Zip | 29607-5495
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Country | US
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Telephone | 864-800-9263
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Fax | 864-210-5209
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Authorized Official
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Title or Position | OWNER
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Name | MARY ANIS HANNA
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Credential | HANNA
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Telephone | 864-800-9263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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