Provider Demographics
NPI:1790316933
Name:KAYLI ENTERPRISES/BEAUTIFUL REFLEKTIONS
Entity Type:Organization
Organization Name:KAYLI ENTERPRISES/BEAUTIFUL REFLEKTIONS
Other - Org Name:BEAUTIFUL REFLEKTIONS SALON AND HAIRLOSS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TRICHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-552-9268
Mailing Address - Street 1:104 GIDNEY ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-5806
Mailing Address - Country:US
Mailing Address - Phone:980-552-9268
Mailing Address - Fax:
Practice Address - Street 1:104 GIDNEY ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-5806
Practice Address - Country:US
Practice Address - Phone:980-552-9268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty