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NPI Code Detail

MEDICARE: DREAM HAIR CARE

MEDICARE: DREAM HAIR CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1335E00000XProsthetic/Orthotic Supplier

General Provider Information

NPI Number : 1154945418
Entity Type Code : Organization
Provider Name (Legal Business Name) : DREAM HAIR CARE
Provider Business Mailing Address
First Line : 4401 W 4TH ST STE E
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-1006
Country : US
Telephone Number : 601-618-5467
Fax Number : 208-400-5298
Provider Business Practice Location Address
First Line : 4401 W 4TH ST STE E
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-1006
Country : US
Telephone Number : 601-618-5467
Fax Number : 208-400-5298
Authorized Official
Title or Position : OWNER
Name : DARNISHA WINTERS
Credential :
Telephone Number : 601-618-5467
Provider Enumeration Date : 06/02/2020
Last Update Date : 06/02/2020

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Directions to “DREAM HAIR CARE ” Practice Location

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