Organization
REEDSIGNZ SALON CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LASHUNDRA JOHNSON CERTIFIED HAIR LOSS (PRESIDENT)
(817) 505-5072
Entity
Organization
Contact information
Practice address
4256 LORIN AVE, FORT WORTH, TX 76105-4216
(817) 505-5072
Mailing address
4256 LORIN AVE, FORT WORTH, TX 76105-4216
(817) 505-5072
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46-5332172
TAXPAYER IDENTIFICATION NUMBER
TX
Enumeration date
12/21/2017
Last updated
06/16/2018
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