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Organization

SHANNON NICOLE BEAUTY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHANNON PARKER (OWNER)
(516) 418-4201
Entity
Organization

Contact information

Practice address
239 FOURTH AVENUE STE 1401 #1462, PITTSBURG, PA 15222
(516) 418-4201
Mailing address
2147 S LAMBERT ST, PHILADELPHIA, PA 19145-3503
(516) 418-4201

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary

Other

Enumeration date
10/06/2020
Last updated
10/05/2021
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