Provider Demographics
NPI:1164909586
Name:4K TRESSES
Entity Type:Organization
Organization Name:4K TRESSES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NYKOI
Authorized Official - Middle Name:R
Authorized Official - Last Name:POTTS-SLOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-860-2114
Mailing Address - Street 1:1008 KENDALE CIR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-6872
Mailing Address - Country:US
Mailing Address - Phone:404-860-2114
Mailing Address - Fax:757-482-4840
Practice Address - Street 1:1220 EXECUTIVE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:404-860-2114
Practice Address - Fax:757-482-4840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier