Provider Demographics
NPI:1588331235
Name:FIXXD BEAUTY BUNDLES
Entity type:Organization
Organization Name:FIXXD BEAUTY BUNDLES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRARISHA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:DENMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-541-0847
Mailing Address - Street 1:2502 W HIGHLAND AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85017-4065
Mailing Address - Country:US
Mailing Address - Phone:623-335-2887
Mailing Address - Fax:623-321-6199
Practice Address - Street 1:2502 W HIGHLAND AVE STE 102
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-4065
Practice Address - Country:US
Practice Address - Phone:623-335-2887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIXXD BEAUTY BUNDLES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-29
Last Update Date:2021-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier