# JAZZ HAIR INSTITUTE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053657924
- **Authorized official:** KELLEY JORDAN (COSMETOLOGIST)
- **Authorized official phone:** (314) 389-5770

## Contact information

- **Practice address:** 3950 COOK AVE, SAINT LOUIS, MO 63113-3402
- **Practice address phone:** (314) 258-7061
- **Mailing address:** 3950 COOK AVE, SAINT LOUIS, MO 63113
- **Mailing address phone:** (314) 258-7061

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224P00000X | Prosthetist | — | NULL | Yes |
| 224P00000X | Prosthetist | — | — | Yes |

## Other

- **Enumeration date:** 12/21/2012
- **Last updated:** 01/20/2017