Organization
ARTISTIC ROSE SALON, LLC
Active
Other names
Authentic Wig Shop & Salon, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSEMARIE MOHAMMED (PRESIDENT)
(571) 246-2438
Entity
Organization
Contact information
Practice address
216 MISTY POND TER, PURCELLVILLE, VA 20132-6149
(571) 246-2438
Mailing address
PO BOX 2573, PURCELLVILLE, VA 20134-4573
(571) 246-2438
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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