Organization
MANETAIN HAIR STUDIO AND ACCESSORIES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAQUANA L HEYWARD (CERTIFIED HAIR LOSS SPECIALIST)
(843) 441-4374
Entity
Organization
Contact information
Practice address
2451 BOUNDARY ST, B, BEAUFORT, SC 29906-3770
(843) 441-4374
Mailing address
158 DULAMO RD, SAINT HELENA ISLAND, SC 29920-3311
(843) 441-4374
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68373
CERTIFIED HAIR LOSS SPECIALIST
SC
Enumeration date
09/14/2015
Last updated
09/14/2015
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