Organization
DIVINE IMAGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONI EVERAGE LICENSED COSMETOLOGI (OWNER)
(513) 628-3782
Entity
Organization
Contact information
Practice address
1806 NORTHCUT AVE, CINCINNATI, OH 45237-6026
(937) 727-3705
Mailing address
1806 NORTHCUT AVE, CINCINNATI, OH 45237-6026
(513) 628-3782
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
11/29/2022
Last updated
07/12/2023
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