Organization
LUSH HAIR AFFAIR
Active
Other names
Lush Hair Affair Rx
Organization subpart
No
Provider details
NPI number
Authorized official
KIANTE L THOMPSON (OWNER/CRANIAL PROSTHESIS SPECIALIST)
(803) 729-6940
Entity
Organization
Contact information
Practice address
136-4 FORUM DRIVE, #1055, COLUMBIA, SC 29229
(803) 427-9202
(803) 710-7307
Mailing address
136-4 FORUM DRIVE, #1055, COLUMBIA, SC 29229
(803) 710-7307
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/16/2021
Last updated
08/08/2021
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