Organization
IN AAW HAIR & BEAUTY EMPORIUM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AKILAH WILLIAMS (OWNER)
(779) 456-5667
Entity
Organization
Contact information
Practice address
1911 TRACY DR APT 3A, BLOOMINGTON, IL 61704-7350
(309) 530-9415
Mailing address
1911 TRACY DR APT 3A, BLOOMINGTON, IL 61704-7350
(309) 530-9415
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
01/06/2021
Last updated
01/06/2021
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