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General NPI Number Information
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NPI Number | 1790179489
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Entity Type | Organization
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Legal Business Name | VAMOUSSE/YOUR SALON REFUGE
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 703 3RD AVE N
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City | BIRMINGHAM
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State | AL
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Zip | 35203-3023
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Country | US
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Telephone | 205-202-2665
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Fax |
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Provider Business Mailing Address
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Address Line | 703 3RD AVE N
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City | BIRMINGHAM
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State | AL
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Zip | 35203-3023
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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 | OWNER
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Name | TEMESHA DEBARDLABON
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Credential |
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Telephone | 205-202-2665
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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 |
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License Number State |
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