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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