Provider Demographics
NPI:1073367637
Name:LUXE NOIR HEALTH, P.C.
Entity Type:Organization
Organization Name:LUXE NOIR HEALTH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALYSA
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:347-216-7560
Mailing Address - Street 1:3145 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HAPEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1163
Mailing Address - Country:US
Mailing Address - Phone:404-228-1874
Mailing Address - Fax:
Practice Address - Street 1:3145 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1163
Practice Address - Country:US
Practice Address - Phone:404-228-1874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty