# ADVANCED HAIR CARE & WELLNESS SPA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952153249
- **Authorized official:** NICOLE SHEMWELL (CERTIFIED HAIR LOSS SPECIALIST)
- **Authorized official phone:** (904) 670-0906

## Contact information

- **Practice address:** 1021 OAK ST STE 129, JACKSONVILLE, FL 32204-3905
- **Practice address phone:** (904) 670-0906
- **Mailing address:** 14587 FALLING WATERS DR, JACKSONVILLE, FL 32258-1162
- **Mailing address phone:** (904) 333-0868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1744P3200X | Prosthetics Case Management | — | NULL | — |
| 1744P3200X | Prosthetics Case Management | — | — | — |
| 225000000X | Orthotic Fitter | — | NULL | — |
| 225000000X | Orthotic Fitter | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 04/02/2024
- **Last updated:** 04/02/2024