Provider Demographics
NPI:1386055721
Name:HEALINGSTRANDS SALON & MORE
Entity type:Organization
Organization Name:HEALINGSTRANDS SALON & MORE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TEQUILLA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LIC EDUCATOR COS AAS
Authorized Official - Phone:770-533-1844
Mailing Address - Street 1:392 LINWOOD DR APT 2-6
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-1151
Mailing Address - Country:US
Mailing Address - Phone:770-533-1844
Mailing Address - Fax:
Practice Address - Street 1:392 LINWOOD DR APT 2-6
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1151
Practice Address - Country:US
Practice Address - Phone:770-533-1844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier