Provider Demographics
NPI:1164104584
Name:INSIDE OUT HAIR SOLUTIONS LLC
Entity Type:Organization
Organization Name:INSIDE OUT HAIR SOLUTIONS LLC
Other - Org Name:INSIDE OUT HAIR SOLUTIONS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:CRANIAL PROTHESIS
Authorized Official - Phone:770-380-8821
Mailing Address - Street 1:1445 WOODMONT LN NW # 1189
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2866
Mailing Address - Country:US
Mailing Address - Phone:770-380-8821
Mailing Address - Fax:678-669-1780
Practice Address - Street 1:2575 WHITEHAVEN DRIVE
Practice Address - Street 2:SUITE 116
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064
Practice Address - Country:US
Practice Address - Phone:770-380-8821
Practice Address - Fax:678-669-1780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier