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Organization

HAIRZONE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ANNAIL FORT CERTIFIED HAIRLOSS S (OWNER)
(334) 280-3930
Entity
Organization

Contact information

Practice address
3009 MCGEHEE RD, B, MONTGOMERY, AL 36111-2202
(334) 280-3930
Mailing address
3009 MCGEHEE RD, B, MONTGOMERY, AL 36111-2202
(334) 280-3930

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
59208
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1497129159
CERTIFIED HAIRLOSS SPECIALIST
AL
Enumeration date
06/01/2016
Last updated
06/01/2016
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