Organization
ADVANCED HAIR CARE & WELLNESS SPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE SHEMWELL (CERTIFIED HAIR LOSS SPECIALIST)
(904) 670-0906
Entity
Organization
Contact information
Practice address
1021 OAK ST STE 129, JACKSONVILLE, FL 32204-3905
(904) 670-0906
Mailing address
14587 FALLING WATERS DR, JACKSONVILLE, FL 32258-1162
(904) 333-0868
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
225000000X
Orthotic Fitter
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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