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General NPI Number Information
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NPI Number | 1922341940
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Entity Type | Organization
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Legal Business Name | HAIR INFINITI WELLNESS SALON LLC
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Dates
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Enumeration Date | 03/27/2013
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Last Update Date | 03/27/2013
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Provider Practice Location Address
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Address Line | 520 COLLINS AIKMAN DR SUITE E205
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City | CHARLOTTE
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State | NC
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Zip | 28262-3317
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Country | US
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Telephone | 704-726-5467
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Fax |
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Provider Business Mailing Address
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Address Line | 520 COLLINS AIKMAN DR SUITE E205
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City | CHARLOTTE
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State | NC
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Zip | 28262-3317
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Country | US
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Telephone | 704-726-5467
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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 | MRS. ANDREANA RAMSEUR BLANTON
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Credential |
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Telephone | 704-726-5467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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