Organization
STAGE 1 HAIR LOSS REPLACEMENT & SALON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. ALANDA KNIGHT TILLMAN (PRESIDENT)
(601) 773-0241
Entity
Organization
Contact information
Practice address
216 MAIN ST., MEADVILLE, MS 39653
(601) 384-4532
(601) 384-4532
Mailing address
PO BOX 240, MEADVILLE, MS 39653-0240
(601) 384-4532
(601) 384-4532
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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