Organization
ELITE HAIR & BEAUTY SUPPLY LLC
Active
Other names
Elite Hair & Beauty Supply LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LAKETTA GILL (EMPLOYEE)
(228) 596-6834
Entity
Organization
Contact information
Practice address
1822 15TH ST STE 3, GULFPORT, MS 39501-2104
(228) 313-1250
Mailing address
1822 15TH ST STE 3, GULFPORT, MS 39501-2104
(228) 313-1250
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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