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General NPI Number Information
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NPI Number | 1982844437
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Entity Type | Organization
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Legal Business Name | EL HAIJJ SALON ANDS SPA
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Dates
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Enumeration Date | 02/24/2009
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 1119 20TH ST
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City | HUNTINGTON
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State | WV
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Zip | 25703-2021
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Country | US
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Telephone | 304-522-7553
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8098
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City | HUNTINGTON
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State | WV
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Zip | 25705-0098
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Country | US
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Telephone | 304-522-7553
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SUSAN JOYCE HAGE
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Credential |
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Telephone | 304-522-7553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State | WV
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