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General NPI Number Information
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NPI Number | 1952215345
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Entity Type | Organization
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Legal Business Name | MANE HAIR LOSS SOLUTIONS
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 2510 DRUMCLIFF CT
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City | HEPHZIBAH
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State | GA
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Zip | 30815-6621
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Country | US
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Telephone | 803-906-2558
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Fax |
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Provider Business Mailing Address
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Address Line | 246 ROBT DANEL JR PKWY # 1225
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City | AUGUSTA
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State | GA
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Zip | 30909-0803
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Country | US
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Telephone | 803-906-2558
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EBONEE HOUSEWORTH
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Credential |
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Telephone | 803-906-2558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NULL
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Taxonomy #2
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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 | NULL
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