Provider Demographics
NPI:1922514439
Name:CURL-UP & RELAX SALON AND HAIR LOSS CENTER
Entity Type:Organization
Organization Name:CURL-UP & RELAX SALON AND HAIR LOSS CENTER
Other - Org Name:JOSEPHINE P ODOM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:ODOM
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED HAIR LOSS
Authorized Official - Phone:423-595-0652
Mailing Address - Street 1:3236 WILCOX BLVD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-1071
Mailing Address - Country:US
Mailing Address - Phone:423-595-0652
Mailing Address - Fax:
Practice Address - Street 1:3236 WILCOX BLVD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-1071
Practice Address - Country:US
Practice Address - Phone:423-595-0652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1744P3200X
TN1744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty