Organization
DIVINE LASH & BEAUTY BAR
Active
Other names
Divine Lash & Beauty Bar, Divine Luxury Bundles
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY MOORE (OWNER/AESTTHETICIAN)
(414) 202-6350
Entity
Organization
Contact information
Practice address
10520 N BAEHR RD STE M, MEQUON, WI 53092-6701
(262) 417-8385
(414) 202-6350
Mailing address
10520 N BAEHR RD STE M, MEQUON, WI 53092-6701
(262) 417-8385
(414) 202-6350
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
08/09/2023
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