Organization
GRACE & BEAUTY HAIR RESTORATION AND TREATMENT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JELEVA CARR (OWNER/MANAGER)
(404) 366-4429
Entity
Organization
Contact information
Practice address
5891 ASH ST, SUITE B, FOREST PARK, GA 30297-3016
(404) 366-4429
Mailing address
5891 ASH ST, SUITE B, FOREST PARK, GA 30297-3016
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO084847
GA
Other
Enumeration date
12/07/2015
Last updated
12/07/2015
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