Organization
PERMANENT MAKE UP ARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE BYBOTH - MALMIN (OWNER)
(407) 574-8383
Entity
Organization
Contact information
Practice address
236 CRETIN AVE S, SAINT PAUL, MN 55105-1259
(612) 332-0142
Mailing address
236 CRETIN AVE S, SAINT PAUL, MN 55105-1259
(612) 332-0142
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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