MEDICARE: PHD HAIR SOLUTIONS 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
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1841896842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHD HAIR SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	4880 LOWER ROSWELL RD STE 106
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30068-4300
Country	:	US
Telephone Number	:	404-988-6645
Fax Number	:

Provider Business Practice Location Address
First Line	:	4880 LOWER ROSWELL RD STE 106
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30068-4300
Country	:	US
Telephone Number	:	404-988-6645
Fax Number	:

Authorized Official
Title or Position	:	OWNER / CLINICAL DIRECTOR
Name	:	MARTHA TANESHA HINES
Credential	:
Telephone Number	:	404-988-6645

Provider Enumeration Date	:	12/07/2020
Last Update Date	:	06/02/2026

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Directions to “PHD HAIR SOLUTIONS LLC ” Practice Location

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