Provider Demographics
NPI:1568965630
Name:MOTALEEN TOP TRENDZ HAIR D'ZINE
Entity Type:Organization
Organization Name:MOTALEEN TOP TRENDZ HAIR D'ZINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/HAIR LOSS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MOTALEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD-RATTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-918-5173
Mailing Address - Street 1:6543 OLD LUMBERTON RD
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-6267
Mailing Address - Country:US
Mailing Address - Phone:910-918-5173
Mailing Address - Fax:
Practice Address - Street 1:8225 OLD HIGHWAY 74
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:NC
Practice Address - Zip Code:28438
Practice Address - Country:US
Practice Address - Phone:910-654-6030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty