Organization
EVOLUTION SKINCARE STUDIO
Active
Parent organization
EVOLUTION SKINCARE STUDIO
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVOLUTION SKINCARE STUDIO
Authorized official
TRINA M HARPER (CEO)
(313) 779-1687
Entity
Organization
Contact information
Practice address
24777 GREENFIELD RD, SOUTHFIELD, MI 48075-3065
(313) 779-1687
Mailing address
24777 GREENFIELD RD, SOUTHFIELD, MI 48075-3065
(313) 779-1687
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/25/2021
Last updated
12/25/2021
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