Organization
FOREVER DIAZ SALON & SPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CANDACE JOY DIAZ (CEO)
(443) 854-3307
Entity
Organization
Contact information
Practice address
8237 PHILADELPHIA RD, ROSEDALE, MD 21237-2865
(410) 497-0782
Mailing address
8237 PHILADELPHIA RD, ROSEDALE, MD 21237-2865
(410) 497-0782
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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