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Organization
RESTORED CROWN HAIR RESTORATION CLINIC LLC
Active
Organization
RESTORED CROWN HAIR RESTORATION CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAKARA HARRIS TRICHOLOGIST (OWNER)
(443) 686-2487
Entity
Organization
Contact information
Practice address
3766 US HIGHWAY 17 STE 102, RICHMOND HILL, GA 31324-8872
(912) 312-7272
Mailing address
3766 US HIGHWAY 17 STE 102, RICHMOND HILL, GA 31324-8872
(912) 312-7272
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
261Q00000X
Clinic/Center
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
10/24/2023
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