MEDICARE: ALLURE ME THE HAIR ESTATE

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
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1770121956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLURE ME THE HAIR ESTATE

Provider Business Mailing Address
First Line	:	8133 WAKE RD
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-9531
Country	:	US
Telephone Number	:	919-630-0623
Fax Number	:

Provider Business Practice Location Address
First Line	:	1910 SEDWICK RD
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-7807
Country	:	US
Telephone Number	:	919-630-0623
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANTONIA GEORGE
Credential	:
Telephone Number	:	919-630-0623

Provider Enumeration Date	:	12/18/2019
Last Update Date	:	12/18/2019

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Directions to “ALLURE ME THE HAIR ESTATE ” Practice Location

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