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Organization
SALON HAIR FORTE
Active
Organization
SALON HAIR FORTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GWENDOLYN C COXUM (OWNER)
(919) 464-0355
Entity
Organization
Contact information
Practice address
1411 W CUMBERLAND ST, DUNN, NC 28334-4503
(919) 464-0355
Mailing address
604 TILGHMAN DR APT 5B, DUNN, NC 28334-5528
(919) 464-0355
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR1100X
Research Clinic/Center
—
—
261QV0200X
VA Clinic/Center
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
03/07/2023
Last updated
03/07/2023
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