Organization
STYLING ICONZ HAIR REPLACEMENT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGEL BLOSSOM MCGOWAN-ROBINSON COS. MD (OWNER)
(704) 310-8893
Entity
Organization
Contact information
Practice address
7309 E INDEPENDENCE BLVD, 25, CHARLOTTE, NC 28227-9476
(704) 310-8893
Mailing address
7309 E INDEPENDENCE BLVD STE 25, CHARLOTTE, NC 28227-9439
(704) 310-8893
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
185683
NC
Other
Enumeration date
12/11/2012
Last updated
12/11/2012
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