Organization
K&T RAW HAIR COLLECTION
Active
Other names
Refreshed Locs
Organization subpart
No
Provider details
NPI number
Authorized official
KETURHA REESE (CEO)
(813) 403-3906
Entity
Organization
Contact information
Practice address
5104 COUNTRY SIDE DR, TAMPA, FL 33624-2013
(813) 403-3906
Mailing address
5104 COUNTRY SIDE DR, TAMPA, FL 33624-2013
(813) 403-3906
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
05/26/2019
Last updated
01/26/2021
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