Organization
THE LUXE HAIR BAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAKEETA ANN WINFREY PHD (CEO)
(404) 993-0532
Entity
Organization
Contact information
Practice address
2274 SALEM RD SE, SUITE 106-199, CONYERS, GA 30013-2097
(404) 993-0532
Mailing address
2274 SALEM RD SE, CONYERS, GA 30013-2097
(404) 993-0532
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760793616
NPI
GA
Enumeration date
12/12/2016
Last updated
12/12/2016
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