Organization
IAN BRADLEY HAIR SALON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA RALEE MCCOY (MANAGER)
(478) 845-1210
Entity
Organization
Contact information
Practice address
3902 NORTHSIDE DR STE A3, MACON, GA 31210-2459
(478) 845-1210
Mailing address
222 JOYCLIFF CIR, MACON, GA 31211-7040
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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