Provider Demographics
NPI:1821509951
Name:SALON JOIERE LLC
Entity Type:Organization
Organization Name:SALON JOIERE LLC
Other - Org Name:SALON JOIERE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DYNIECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-799-6807
Mailing Address - Street 1:5284 FLOYD RD SW UNIT 1669
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-6115
Mailing Address - Country:US
Mailing Address - Phone:770-799-6807
Mailing Address - Fax:
Practice Address - Street 1:2575 WHITE HAVEN DR
Practice Address - Street 2:STE 100, SALON 121
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3006
Practice Address - Country:US
Practice Address - Phone:770-799-6807
Practice Address - Fax:866-799-9972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACOSA0521701744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty