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NPI Code Detail

MEDICARE: MORRIS &QUOW NON-SURGICAL HAIR REPLACEMENT CLINIC, LLC

MEDICARE: MORRIS &QUOW NON-SURGICAL HAIR REPLACEMENT CLINIC, LLC
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
11744P3200XProsthetics Case Management

General Provider Information

NPI Number : 1760217699
Entity Type Code : Organization
Provider Name (Legal Business Name) : MORRIS &QUOW NON-SURGICAL HAIR REPLACEMENT CLINIC, LLC
Provider Business Mailing Address
First Line : 1019 HOPE MILLS RD
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-4234
Country : US
Telephone Number : 910-485-3111
Fax Number :
Provider Business Practice Location Address
First Line : 1019 HOPE MILLS RD
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-4234
Country : US
Telephone Number : 910-485-3111
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. LUMUMBA QUOW
Credential : DPB
Telephone Number : 910-709-8624
Provider Enumeration Date : 09/02/2024
Last Update Date : 09/12/2024

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