Provider Demographics
NPI:1922426600
Name:SAVAGE HAIR & BODY TREATMENTS
Entity Type:Organization
Organization Name:SAVAGE HAIR & BODY TREATMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-500-2264
Mailing Address - Street 1:1302 MONDAVI CIR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-5331
Mailing Address - Country:US
Mailing Address - Phone:760-500-2264
Mailing Address - Fax:
Practice Address - Street 1:1302 MONDAVI CIR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-5331
Practice Address - Country:US
Practice Address - Phone:760-500-2264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty