Organization
VOLUMINOUS VIRGIN HAIR BOUTIQUE
Active
Other names
Sou Consultants
Organization subpart
No
Provider details
NPI number
Authorized official
KENYA DOMINIC (MEMBER MANAGER)
(912) 877-7797
Entity
Organization
Contact information
Practice address
445 ELMA G MILES PKWY, 207, HINESVILLE, GA 31313-3230
(912) 877-7797
Mailing address
445 EG.MILES PARKWAY, 207, HINESVILLE, GA 31313-9623
(912) 877-7797
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
20725
GA
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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