Provider Demographics
NPI:1639681752
Name:STUDIO GLAMOUR HAIR SALON & RESTORATION CENTER
Entity Type:Organization
Organization Name:STUDIO GLAMOUR HAIR SALON & RESTORATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-415-4947
Mailing Address - Street 1:2344 EBENEZER RD STE C
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8266
Mailing Address - Country:US
Mailing Address - Phone:803-493-9895
Mailing Address - Fax:
Practice Address - Street 1:2344 EBENEZER RD STE C
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8266
Practice Address - Country:US
Practice Address - Phone:803-493-9895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty