Provider Demographics
NPI:1306481676
Name:BIG HEADS BARBER SALON
Entity type:Organization
Organization Name:BIG HEADS BARBER SALON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:FIDEL
Authorized Official - Last Name:SOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-245-5285
Mailing Address - Street 1:6161 BUSCH BLVD STE 56
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2548
Mailing Address - Country:US
Mailing Address - Phone:614-245-5285
Mailing Address - Fax:
Practice Address - Street 1:6161 BUSCH BLVD STE 56
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2548
Practice Address - Country:US
Practice Address - Phone:614-245-5285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty