Provider Demographics
NPI:1043497621
Name:TRANQUILITY SALON & SPA
Entity Type:Organization
Organization Name:TRANQUILITY SALON & SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-525-6161
Mailing Address - Street 1:320 PARKWAY DR NE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1213
Mailing Address - Country:US
Mailing Address - Phone:404-525-6161
Mailing Address - Fax:404-525-6164
Practice Address - Street 1:320 PARKWAY DR NE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1213
Practice Address - Country:US
Practice Address - Phone:404-525-6161
Practice Address - Fax:404-525-6164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-26
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier