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NPI Code Detail

MEDICARE: TO THE ROOT OF THINGS

MEDICARE: TO THE ROOT OF THINGS
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
1332BC3200XCustomized Equipment (DME)

General Provider Information

NPI Number : 1679819692
Entity Type Code : Organization
Provider Name (Legal Business Name) : TO THE ROOT OF THINGS
Provider Business Mailing Address
First Line : 6077 BENA CT
Second Line :
City : UNION CITY
State : GA
Zip : 30291-1044
Country : US
Telephone Number : 770-256-8467
Fax Number :
Provider Business Practice Location Address
First Line : 6077 BENA CT
Second Line :
City : UNION CITY
State : GA
Zip : 30291-1044
Country : US
Telephone Number : 770-256-8467
Fax Number :
Authorized Official
Title or Position : HAIR LOSS SPECIALIST
Name : BRANDIE NICHOL JACKSON
Credential :
Telephone Number : 770-256-8467
Provider Enumeration Date : 12/19/2012
Last Update Date : 12/19/2012

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Directions to “TO THE ROOT OF THINGS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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