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Organization

HAIR CLINIQUE SALON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DIONNE LINDSAY MOLDEN (OWNER)
(770) 912-4661
Entity
Organization

Contact information

Practice address
3500 GWINNETT PLACE DR, SUITE 5, DULUTH, GA 30096-4700
(770) 912-4661
Mailing address
3500 GWINNETT PLACE DR, SUITE 5, DULUTH, GA 30096-4700
(770) 912-4661

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO100223
GA

Other

Enumeration date
09/27/2015
Last updated
09/27/2015
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