Organization
INDEPENDENT SALON GROUP INC
Active
Other names
Synergy Trichology Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALTALISIA D HARALSON (CEO)
(678) 491-0110
Entity
Organization
Contact information
Practice address
4830 STEEPLECHASE CT, POWDER SPRINGS, GA 30127-2567
(678) 401-0366
Mailing address
4830 STEEPLECHASE COURT, POWDER SPRINGS, GA 30127
(678) 401-0366
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
CO087243
GA
Other
Enumeration date
11/17/2011
Last updated
11/17/2011
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