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General NPI Number Information
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NPI Number | 1942791421
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Entity Type | Organization
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Legal Business Name | UNIQUELY URS HAIR RESTORATION CENTER
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1144 SMALLWOOD DR W # E1
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City | WALDORF
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State | MD
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Zip | 20603-4759
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Country | US
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Telephone | 301-535-6975
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Fax |
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Provider Business Mailing Address
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Address Line | 2304 OXFORD SHIRE CT
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City | WALDORF
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State | MD
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Zip | 20603-3215
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Country | US
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Telephone | 301-535-6975
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Fax | 240-213-2551
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Authorized Official
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Title or Position | OWNER
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Name | MELODY A ROBINSON
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Credential |
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Telephone | 301-535-6975
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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 | 222859
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License Number State | MD
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