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Organization

BATES FAMILY HAIR AFFAIR, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIFFANY DEMETRIA BATES MASTER DEGREE M.ED. (CERTIFIED HAIR LOSS SPECIALIST)
(803) 300-0273
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
332B00000X
Durable Medical Equipment & Medical Supplies
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
08/18/2022
Last updated
08/18/2022
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