Organization
DIVINE HAIR DESIGN SALON & BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAH JANE HORTON (OWNER)
(254) 768-0058
Entity
Organization
Contact information
Practice address
2201 W STAN SCHLUETER LOOP SUITE A-400, KILLEEN, TX 76549-7654
(254) 768-0058
Mailing address
2201 W STAN SCHLUETER LOOP SUITE A-400, KILLEEN, TX 76549
(254) 768-0058
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
02/18/2021
Last updated
02/02/2023
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