Organization
NINA ROSS HAIR THERAPY, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANINA LASSITER HAIR LOSS SPECIALIST (OWNER)
(678) 561-4522
Entity
Organization
Contact information
Practice address
6111 PEACHTREE DUNWOODY RD STE E101, ATLANTA, GA 30328-4513
(678) 561-4522
Mailing address
6111 PEACHTREE DUNWOODY RD STE E101, ATLANTA, GA 30328-4513
(678) 561-4522
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
1744P3200X
GA
332B00000X
Durable Medical Equipment & Medical Supplies
1744P3200X
GA
Other
Enumeration date
03/22/2016
Last updated
03/08/2018
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