Organization
RESTORED CROWN HAIR RESTORATION CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAKARA HARRIS TRICHOLOGIST (OWNER)
(443) 686-2487
Entity
Organization
Contact information
Practice address
3766 US HIGHWAY 17 STE 102, RICHMOND HILL, GA 31324-8872
(912) 312-7272
Mailing address
3766 US HIGHWAY 17 STE 102, RICHMOND HILL, GA 31324-8872
(912) 312-7272
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
261Q00000X
Clinic/Center
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
10/24/2023
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