Organization
BATES FAMILY HAIR AFFAIR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIFFANY DEMETRIA BATES RC, M.ED. (CRANIAL PROSTHESIS SPECIALIST)
(803) 266-2727
Entity
Organization
Contact information
Practice address
13192 CHURCH ST, WILLISTON, SC 29853-5818
(803) 266-2727
Mailing address
42 JOHNSON LN, WILLISTON, SC 29853-5432
(803) 300-0273
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
05/23/2021
Last updated
05/23/2021
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