Organization
SALON ETC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY HIMES (OWNER)
(319) 533-4766
Entity
Organization
Contact information
Practice address
4403 1ST AVE SE STE 104, CEDAR RAPIDS, IA 52402-3221
(319) 299-4433
Mailing address
4403 1ST AVE SE STE 104, CEDAR RAPIDS, IA 52402-3221
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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