Organization
IAN BRADLEY HAIR SALON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA R MCCOY (OWNER)
(478) 714-4302
Entity
Organization
Contact information
Practice address
3902 NORTHSIDE DR STE A3, MACON, GA 31210-2459
(478) 845-1210
(478) 210-5078
Mailing address
222 JOYCLIFF CIR, MACON, GA 31211-7040
(478) 714-4302
(478) 210-5078
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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