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Organization

SPECIAL EFFECT HAIR STUDIO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERIKA R SANDERS (COSMETOLOGIST)
(617) 265-0669
Entity
Organization

Contact information

Practice address
1454 DORCHESTER AVE, DORCHESTER, MA 02122-1343
(617) 265-0669
Mailing address
1454 DORCHESTER AVE, DORCHESTER, MA 02122-1343
(617) 265-0669

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
1122002
MA

Other

Enumeration date
05/28/2010
Last updated
05/28/2010
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