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Organization

ISLAY LLC

Active
Other names
AKUA HAIR CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
TRAI'SHAUN D BEARD ADVANCED COSMETOLOGI (CEO)
(419) 709-9663
Entity
Organization

Contact information

Practice address
524 PARK AVE W, MANSFIELD, OH 44906-3720
(419) 709-9663
Mailing address
524 PARK AVE W, MANSFIELD, OH 44906-3720
(419) 709-9663

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary

Other

Enumeration date
02/15/2019
Last updated
02/15/2019
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