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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