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Organization
TO THE ROOT OF THINGS
Active
Organization
TO THE ROOT OF THINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDIE NICHOL JACKSON (HAIR LOSS SPECIALIST)
(770) 256-8467
Entity
Organization
Contact information
Practice address
6077 BENA CT, UNION CITY, GA 30291-1044
(770) 256-8467
Mailing address
6077 BENA CT, UNION CITY, GA 30291-1044
(770) 256-8467
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
12/19/2012
Last updated
12/19/2012
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