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Organization

LUX GLAMOROUS WIGS & COMPANY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATSY GALLIAN (DIRECTOR)
(214) 437-2272
Entity
Organization

Contact information

Practice address
308 UNIONVILLE INDIAN TRAIL RD W STE C, INDIAN TRAIL, NC 28079-5551
(757) 289-2020
Mailing address
308 UNIONVILLE INDIAN TRAIL RD W STE C, INDIAN TRAIL, NC 28079-5551
(757) 289-2020

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C63644
COSMETOLOGY LICENSE
Enumeration date
08/19/2020
Last updated
04/20/2021
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