Organization
KRISTYLE'S KREATIONS HAIR STUDIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTAL D FULLER (OWNER)
(813) 932-0022
Entity
Organization
Contact information
Practice address
1321 W WATERS AVE STE 104, TAMPA, FL 33604-2800
(813) 932-0022
Mailing address
1321 W. WATERS AVENUE SUITE #104, TAMPA, FL 33604
(813) 932-0022
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
CE9977411
FL
Other
Enumeration date
06/14/2010
Last updated
06/14/2010
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