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General NPI Number Information
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NPI Number | 1720529514
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Entity Type | Organization
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Legal Business Name | LOVELY HAIR SOLUTIONS
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 4701 ATLANTIC AVE
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City | RALEIGH
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State | NC
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Zip | 27604-8108
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Country | US
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Telephone | 252-205-6767
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1142
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City | WILSON
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State | NC
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Zip | 27894-1142
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Country | US
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Telephone | 203-676-4982
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Fax |
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Authorized Official
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Title or Position | HAIR LOSS SPECIALIST
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Name | HELEN BRASWELL COOPER
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Credential | TRICHOLOGIST
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Telephone | 203-676-4982
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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 | C30180
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License Number State | NC
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