Organization
DIVINE BEAUTY SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKESHIA CARHEE (OWNER)
(318) 773-3600
Entity
Organization
Contact information
Practice address
2715 MACKEY PL STE 130, SHREVEPORT, LA 71118-2528
(318) 657-0416
Mailing address
810 POLK ST, MANSFIELD, LA 71052-2414
(318) 657-0416
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/29/2023
Last updated
12/29/2023
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