Organization
IAN BRADLEY HAIR SALON LLC
Active
Organization
IAN BRADLEY HAIR SALON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA R MCCOY (MANAGER)
(478) 714-4302
Entity
Organization
Contact information
Practice address
3902 NORTHSIDE DR STE A3, MACON, GA 31210-2459
(478) 845-1210
Mailing address
3902 NORTHSIDE DR STE A3, MACON, GA 31210-2459
(478) 845-1210
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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