Organization
CAROLINA HAIR REJUVENATION CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKISHA M ASHFORD (PRESIDENT)
(800) 719-0061
Entity
Organization
Contact information
Practice address
651 SAINT ANDREWS RD, COLUMBIA, SC 29210-5112
(800) 719-0061
Mailing address
537 HALLECK LN, COLUMBIA, SC 29229-8096
(800) 719-0061
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
55548
SC
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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