Provider Demographics
NPI:1275947699
Name:LES CHEVEUX DISCOUNT HAIR
Entity Type:Organization
Organization Name:LES CHEVEUX DISCOUNT HAIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:DEMETRIE
Authorized Official - Last Name:COBBLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-279-3596
Mailing Address - Street 1:19011 E SAN TAN BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-7301
Mailing Address - Country:US
Mailing Address - Phone:602-422-1739
Mailing Address - Fax:
Practice Address - Street 1:19011 E SAN TAN BLVD STE 107
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-7301
Practice Address - Country:US
Practice Address - Phone:602-422-1739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier