Organization
BLOWOUT ARTIST SALON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIARA GANDY (OWNER)
(404) 580-0592
Entity
Organization
Contact information
Practice address
4600 ROSWELL RD UNIT D130, ATLANTA, GA 30342-3186
(404) 941-5598
Mailing address
4600 ROSWELL RD UNIT D130, ATLANTA, GA 30342-3186
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/08/2025
Last updated
04/09/2025
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