Provider Demographics
NPI:1326724113
Name:PERRY STYLEZ ENTERPRISE
Entity Type:Organization
Organization Name:PERRY STYLEZ ENTERPRISE
Other - Org Name:PERRY STYLEZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-901-3969
Mailing Address - Street 1:5737 OLD NATIONAL HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-3865
Mailing Address - Country:US
Mailing Address - Phone:833-737-7978
Mailing Address - Fax:
Practice Address - Street 1:5737 OLD NATIONAL HWY SUITE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349
Practice Address - Country:US
Practice Address - Phone:833-737-7978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier