Organization
ANNB HAIR COVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNTIONEEK BOSTON BS,ED (HAIR LOSS SPECIALIST)
(678) 972-4662
Entity
Organization
Contact information
Practice address
1128 LORA SMITH RD, NEWNAN, GA 30265-1924
(678) 744-3440
Mailing address
1128 LORA SMITH RD, NEWNAN, GA 30265-1924
(678) 972-4662
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
01/08/2019
Last updated
07/16/2019
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