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Organization
BATES FAMILY HAIR AFFAIR, LLC
Active
Organization
BATES FAMILY HAIR AFFAIR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIFFANY DEMETRIA BATES RC, M.ED. (CRANIAL PROSTHESIS SPECIALIST)
(803) 266-2727
Entity
Organization
Contact information
Practice address
13192 CHURCH ST, WILLISTON, SC 29853-5818
(803) 266-2727
Mailing address
42 JOHNSON LN, WILLISTON, SC 29853-5432
(803) 300-0273
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
05/23/2021
Last updated
05/23/2021
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