Organization
BEAUTIQUE SALON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARELLE NICOLE LOUDD CERTIFIED HAIR-LOSS (CEO)
(408) 460-8070
Entity
Organization
Contact information
Practice address
1186 S 2ND ST, SAN JOSE, CA 95112-5914
(408) 460-8070
Mailing address
1186 S 2ND ST, SAN JOSE, CA 95112-5914
(408) 460-8070
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
KK482064
CA
Other
Enumeration date
12/22/2017
Last updated
12/22/2017
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