Provider Demographics
NPI:1154145118
Name:ADVENTA'S HAIR CENTER
Entity type:Organization
Organization Name:ADVENTA'S HAIR CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRANIAL PROTHESIS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:ADVENTA
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-675-9173
Mailing Address - Street 1:8641 DORRIS RD STE 150C
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2499
Mailing Address - Country:US
Mailing Address - Phone:770-675-9173
Mailing Address - Fax:
Practice Address - Street 1:8641 DORRIS RD STE 150C
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-2499
Practice Address - Country:US
Practice Address - Phone:770-675-9173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier