Organization
PEDIATRIC HAIR SOLUTIONS CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN E FASSLER 200200218 (MEDICAL DIRECTOR)
(803) 517-5869
Entity
Organization
Contact information
Practice address
19460 OLD JETTON RD, STE 201, CORNELIUS, NC 28031-6456
(704) 909-9414
Mailing address
6923 SHANNON WILLOW RD STE 100, CHARLOTTE, NC 28226-1331
(704) 909-9414
(704) 496-9512
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
200200218
NC
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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