# SCULPT 8 HEAD 2 TOE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sculpt 8 Head 2 Toe
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457046476
- **Authorized official:** TAKELA L BUGG MEDICAL ASSISTANT (OWNER)
- **Authorized official phone:** (706) 254-6837

## Contact information

- **Practice address:** 1117 VILLAGE MAIN ST, STONE MOUNTAIN, GA 30088-4540
- **Practice address phone:** (706) 254-6837
- **Mailing address:** 1117 VILLAGE MAIN ST \# 1117, STONE MOUNTAIN, GA 30088-4540
- **Mailing address phone:** (706) 254-6837

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0800X | Recovery Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/06/2023
- **Last updated:** 04/06/2023