Organization
ELEGANT STYLES BY TIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER MCCRAY (MEDICAL ASSISTANT)
(706) 403-2806
Entity
Organization
Contact information
Practice address
5347 LILA LN, VIRGINIA BEACH, VA 23464-6783
(757) 201-5442
Mailing address
5347 LILA LN, VIRGINIA BEACH, VA 23464-6783
(757) 201-5442
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/25/2021
Last updated
05/18/2021
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