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Organization

MULBERRY WELLNESS SALON LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. RAMONA J WASHINGTON CERTIFIED HAIR LOSS (MASTER COSMETOLOGIST/OWNER)
(334) 868-5189
Entity
Organization

Contact information

Practice address
1734 MULBERRY ST, MONTGOMERY, AL 36106-1524
(334) 819-7249
(334) 819-7249
Mailing address
1734 MULBERRY ST, MONTGOMERY, AL 36106-1524
(334) 819-7249
(334) 819-7249

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
161733
AL
1744P3200X
Prosthetics Case Management
39089
AL
332BC3200X
Customized Equipment (DME)
161733
AL
335E00000X
Prosthetic/Orthotic Supplier
Primary
39089
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
39089
MASTER COSMETOLOGIST; NON-SURGICAL HAIR REPLACEMENT
AL
Enumeration date
05/28/2012
Last updated
07/31/2013
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