Provider Demographics
NPI:1093255192
Name:LOUSY ENDINGS
Entity Type:Organization
Organization Name:LOUSY ENDINGS
Other - Org Name:LICE CLINICS OF AMERICA- MARIETTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-990-4684
Mailing Address - Street 1:3911 MARY ELIZA TRCE NW STE 250
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-1086
Mailing Address - Country:US
Mailing Address - Phone:678-343-3932
Mailing Address - Fax:
Practice Address - Street 1:3911 MARY ELIZA TRCE NW STE 250
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-1086
Practice Address - Country:US
Practice Address - Phone:678-343-3932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty