Organization
EYE KANDY LASHES BEAUTY BAR & BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORRINE SHARON KNIGHT AMT, CO, (OWNER)
(770) 865-3111
Entity
Organization
Contact information
Practice address
2365 POWDER SPRINGS RD SW, SUITE 1215, MARIETTA, GA 30064-4567
(770) 702-5663
(678) 902-6833
Mailing address
2365 POWDER SPRINGS RD SW, SUITE 1215, MARIETTA, GA 30064-4567
(770) 702-5663
(678) 902-6833
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
COSA051935
GA
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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