MEDICARE: FULL CIRCLE HAIR RESTORATION CENTER, 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

General Provider Information

NPI Number	:	1992289193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FULL CIRCLE HAIR RESTORATION CENTER, LLC

Provider Business Mailing Address
First Line	:	3068 BLACKHOPE DR.
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219
Country	:	US
Telephone Number	:	614-419-1313
Fax Number	:

Provider Business Practice Location Address
First Line	:	3029 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-4421
Country	:	US
Telephone Number	:	614-419-1313
Fax Number	:

Authorized Official
Title or Position	:	HEALTH MANAGEMENT CONSULTANT
Name	:	MRS. MEKA M SAUNDERS
Credential	:
Telephone Number	:	614-893-3581

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	09/24/2018

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