Organization
MIRROR GAZE BEAUTY BAR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS HALL (HAIR REPLACEMENT SPECIALIST)
(704) 750-9290
Entity
Organization
Contact information
Practice address
6631B OLD STATESVILLE RD, CHARLOTTE, NC 28269-1733
(704) 750-9290
Mailing address
5432 VIEWMONT DR, CHARLOTTE, NC 28215-1705
(470) 430-2949
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
01/22/2024
Last updated
01/24/2024
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