Organization
NIRVANA HAIR VA LLC
Active
Organization
NIRVANA HAIR VA LLC
Active
Other names
Nirvana Hair RX, Nirvana Hair Studio, My Custom Desire RX
Organization subpart
No
Provider details
NPI number
Authorized official
MAREE NEWBY-SANDERS (PRESIDENT)
(757) 254-7197
Entity
Organization
Contact information
Practice address
10019 JEFFERSON AVE, NEWPORT NEWS, VA 23605-1044
(757) 254-7197
Mailing address
10019 JEFFERSON AVE, NEWPORT NEWS, VA 23605-1044
(757) 254-7197
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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