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General NPI Number Information
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NPI Number | 1891646071
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Entity Type | Organization
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Legal Business Name | PRECISION SCALP HAIR LLC
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 6040 EARLE BROWN DR STE 104
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-2523
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Country | US
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Telephone | 612-461-4703
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Fax |
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Provider Business Mailing Address
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Address Line | 6040 EARLE BROWN DR STE 104
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-2523
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Country | US
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Telephone | 612-461-9724
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Fax | 612-416-1646
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Authorized Official
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Title or Position | OWNER
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Name | SHAVON RUSH
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Credential |
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Telephone | 612-461-9724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225000000X
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Taxonomy Name | Orthotic Fitter
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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 | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number |
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License Number State |
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Taxonomy #3
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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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