MEDICARE: THE BEAUTIFUL ONES SALON 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
1	1744P3200X	Prosthetics Case Management	121071	OH

General Provider Information

NPI Number	:	1770981631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BEAUTIFUL ONES SALON LLC

Provider Business Mailing Address
First Line	:	16012 CALEDONIA AVE
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-2324
Country	:	US
Telephone Number	:	216-678-0962
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 NOBLE RD
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-1736
Country	:	US
Telephone Number	:	216-678-0962
Fax Number	:

Authorized Official
Title or Position	:	CERTIFIED HAIR LOSS SPECIALIST
Name	:	MS. LASHAWN PATTON
Credential	:
Telephone Number	:	216-678-0962

Provider Enumeration Date	:	12/09/2014
Last Update Date	:	04/23/2019

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Directions to “THE BEAUTIFUL ONES SALON LLC ” Practice Location

Language	Start Address	Practice Location

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