Organization
LABEAUTYANDHAIR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABREA TILLMAN (OWNER/AUTHORIZED OFFICIAL)
(415) 900-7489
Entity
Organization
Contact information
Practice address
460 CITY CENTER DR, ROHNERT PARK, CA 94928-2186
(415) 900-7489
Mailing address
3558 ROUND BARN BLVD STE 200, SANTA ROSA, CA 95403-0991
(415) 900-7489
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/30/2016
Last updated
03/28/2025
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