Organization
SALON ONE TWENTY FOUR L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAVON CHERALE GREEN PROSTHETICSPECIALIST (CRANIAL PROSTHETIC SPECIALIST)
(870) 675-1246
Entity
Organization
Contact information
Practice address
124 E WASHINGTON ST, CAMDEN, AR 71701-4010
(870) 454-7017
(501) 830-4033
Mailing address
PO BOX 444, CAMDEN, AR 71711-0444
(870) 454-7017
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/11/2021
Last updated
12/26/2023
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