Organization
CHANGES STYLING SALON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA BOATWRIGHT (OWNER)
(843) 774-0170
Entity
Organization
Contact information
Practice address
1256 W MAIN ST, DILLON, SC 29536-7926
(843) 774-0170
Mailing address
PO BOX 646, DARLINGTON, SC 29540-0646
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
11/14/2019
Last updated
04/01/2020
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