Organization
XTEND MY HAIR SALON & CO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRENCE RANDELL MITCHELL (OWNER/OPERATOR)
(501) 732-6041
Entity
Organization
Contact information
Practice address
1004 DYER ST, MALVERN, AR 72104-5255
(501) 229-1008
Mailing address
1004 DYER ST, MALVERN, AR 72104-5255
(501) 229-1008
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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