Organization
BEAUTY VENOM HAIR LOSS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY LYKE B.A.MGMT/ NTTI GRAD (CERTIFIED TRICHOLOGY PRACTICTIONER)
(702) 807-1498
Entity
Organization
Contact information
Practice address
7785 N DURANGO DR, SUITE 125, LAS VEGAS, NV 89131-8000
(702) 658-8866
Mailing address
7785 N DURANGO DR, SUITE 125, LAS VEGAS, NV 89131-8000
(702) 658-8866
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
GA
335E00000X
Prosthetic/Orthotic Supplier
—
NV
Other
Enumeration date
06/11/2013
Last updated
04/22/2016
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