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Organization

HAIR & BEAUTY TREATMENT CENTER

Active
Other names
Southern Comfort Medical Supply
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DONECIA PERRIN-SULLIVAN SPECIALIST (OWNER)
(706) 373-9184
Entity
Organization

Contact information

Practice address
524 SHARTOM DR, AUGUSTA, GA 30907-4751
(706) 373-9184
Mailing address
524 SHARTOM DR, AUGUSTA, GA 30907-4751
(706) 373-9184

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary

Other

Enumeration date
11/07/2022
Last updated
11/07/2022
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