Provider Demographics
NPI:1356098362
Name:FLAWLESS KAY KOLLECTION
Entity type:Organization
Organization Name:FLAWLESS KAY KOLLECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:T
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:CPS
Authorized Official - Phone:404-821-1814
Mailing Address - Street 1:1700 NORTHSIDE DR NW STE A7
Mailing Address - Street 2:UNIT 5234
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2695
Mailing Address - Country:US
Mailing Address - Phone:404-821-1814
Mailing Address - Fax:
Practice Address - Street 1:1700 NORTHSIDE DR NW STE A7
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2695
Practice Address - Country:US
Practice Address - Phone:404-821-1814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier