Organization
SCULPT 8 HEAD 2 TOE
Active
Other names
Sculpt 8 Head 2 Toe
Organization subpart
No
Provider details
NPI number
Authorized official
TAKELA L BUGG MEDICAL ASSISTANT (OWNER)
(706) 254-6837
Entity
Organization
Contact information
Practice address
1117 VILLAGE MAIN ST, STONE MOUNTAIN, GA 30088-4540
(706) 254-6837
Mailing address
1117 VILLAGE MAIN ST # 1117, STONE MOUNTAIN, GA 30088-4540
(706) 254-6837
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/06/2023
Last updated
04/06/2023
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