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Organization

EYE CANDY BEAUTY SUPPLY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIFFANY DUSHAWN SAMUELS (OWNER)
(304) 657-7558
Entity
Organization

Contact information

Practice address
208 ADAMS ST, FAIRMONT, WV 26554-2826
(304) 368-0027
Mailing address
200 BRADDOCK ST, FAIRMONT, WV 26554-2208
(304) 657-7558

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
WV

Other

Enumeration date
10/31/2017
Last updated
10/31/2017
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