Provider Demographics
NPI:1477018117
Name:MAYERS, ANDREAD I (CERTIFIED HAIR LOSS)
Entity Type:Individual
Prefix:
First Name:ANDREAD
Middle Name:
Last Name:MAYERS
Suffix:I
Gender:F
Credentials:CERTIFIED HAIR LOSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 640232
Mailing Address - Street 2:
Mailing Address - City:PIKE RD
Mailing Address - State:AL
Mailing Address - Zip Code:36064
Mailing Address - Country:US
Mailing Address - Phone:334-676-3600
Mailing Address - Fax:
Practice Address - Street 1:11123 CHANTILLY PKWY CT UNIT K
Practice Address - Street 2:
Practice Address - City:PIKE ROAD
Practice Address - State:AL
Practice Address - Zip Code:36064-2881
Practice Address - Country:US
Practice Address - Phone:334-676-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL882581744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management