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NPI Code Detail

MEDICARE: MRS. BRITTNEY BASS-GRAY HAIR LOSS SPECIALIST

MEDICARE:  MRS. BRITTNEY  BASS-GRAY  HAIR LOSS SPECIALIST
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
1174400000XSpecialist464164219AL

General Provider Information

NPI Number : 1568852572
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRITTNEY BASS-GRAY HAIR LOSS SPECIALIST
Provider Business Mailing Address
First Line : 1251 BEACON PKWY E
Second Line : UNIT 202
City : BIRMINGHAM
State : AL
Zip : 35209-1069
Country : US
Telephone Number : 205-478-7518
Fax Number :
Provider Business Practice Location Address
First Line : 1251 BEACON PKWY E
Second Line : UNIT 202
City : BIRMINGHAM
State : AL
Zip : 35209-1069
Country : US
Telephone Number : 205-478-7518
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2015
Last Update Date : 11/19/2015

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Directions to “ MRS. BRITTNEY BASS-GRAY HAIR LOSS SPECIALIST” Practice Location

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