Organization
THE GLAM SHOP BY ANITRA SHAREE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITRA NASH PHIFER HAIR LOSS SPECIALIST (OWNER)
(704) 923-1469
Entity
Organization
Contact information
Practice address
120 E MAIN AVE, GASTONIA, NC 28052
(704) 923-1469
Mailing address
3306 TABLE ROCK DR, GASTONIA, NC 28052-5437
(704) 923-1469
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/15/2020
Last updated
09/28/2025
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