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Organization

HIGH PRAISE HAIR BOUTIQUE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ADERINA MICHELLE LEE (OWNER)
(803) 278-0605
Entity
Organization

Contact information

Practice address
139 EDGEWOOD DRIVE, NORTH AUGUSTA, SC 29841
(803) 278-0605
(803) 278-1081
Mailing address
139 EDGEWOOD DRIVE, NORTH AUGUSTA, SC 29841
(803) 278-0605
(803) 278-1081

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
61556
SC

Other

Enumeration date
05/22/2015
Last updated
05/22/2015
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