Organization
AESTHETIC BEAUTY LAB LLC
Active
Organization
AESTHETIC BEAUTY LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONIDA NIKITA MUSTA RN (OWNER)
(612) 749-1703
Entity
Organization
Contact information
Practice address
15875 EMPEROR AVE STE 120, APPLE VALLEY, MN 55124-7803
(612) 749-1703
Mailing address
15875 EMPEROR AVE STE 120, APPLE VALLEY, MN 55124-7803
(612) 749-1703
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/15/2025
Last updated
04/15/2025
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