Provider Demographics
NPI:1205475399
Name:THE GALLERY SALON & SPA INC
Entity type:Organization
Organization Name:THE GALLERY SALON & SPA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:LICHTL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-482-2219
Mailing Address - Street 1:6312 ARGONNE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3902
Mailing Address - Country:US
Mailing Address - Phone:504-482-2219
Mailing Address - Fax:
Practice Address - Street 1:6312 ARGONNE BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-3902
Practice Address - Country:US
Practice Address - Phone:504-482-2219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty