Provider Demographics
NPI:1447599758
Name:INTIMATE TOUCH SALON /NONE SURGICAL HAIR REPLACEMENT
Entity Type:Organization
Organization Name:INTIMATE TOUCH SALON /NONE SURGICAL HAIR REPLACEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NON- SURGICAL HAIR REPLACEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MYHONEY
Authorized Official - Middle Name:ALTROVISE
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MASTER COSMETOLOGIST
Authorized Official - Phone:770-256-8273
Mailing Address - Street 1:3060 PHARR COURT NORTH NW
Mailing Address - Street 2:SUIT 29
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2052
Mailing Address - Country:US
Mailing Address - Phone:770-256-8273
Mailing Address - Fax:
Practice Address - Street 1:3060 PHARR COURT NORTH NW
Practice Address - Street 2:SUIT 29
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2052
Practice Address - Country:US
Practice Address - Phone:770-256-8273
Practice Address - Fax:678-519-4712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACO096835174400000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty