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General NPI Number Information
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NPI Number | 1952069601
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Entity Type | Organization
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Legal Business Name | NATURAL U SALON LLC
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 5440 EXECUTIVE PL STE C
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City | JACKSON
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State | MS
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Zip | 39206-4145
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Country | US
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Telephone | 601-364-2869
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Fax | 601-786-5858
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Provider Business Mailing Address
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Address Line | 5440 EXECUTIVE PL STE C
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City | JACKSON
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State | MS
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Zip | 39206-4145
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Country | US
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Telephone | 601-364-2869
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Fax | 601-786-5858
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Authorized Official
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Title or Position | OWNER/ CRANIAL PROTHESIS
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Name | MS. MELODY SHAVONNE WASHINGTON
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Credential |
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Telephone | 601-364-2869
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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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