Provider Demographics
NPI:1619646353
Name:SELA STYLEZ HAIR LLC.
Entity type:Organization
Organization Name:SELA STYLEZ HAIR LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HAIR REPLACEMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SERENA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-828-1660
Mailing Address - Street 1:2005 OSSABAW DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-3351
Mailing Address - Country:US
Mailing Address - Phone:706-828-1660
Mailing Address - Fax:
Practice Address - Street 1:2005 OSSABAW DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-3351
Practice Address - Country:US
Practice Address - Phone:706-828-1660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-07
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty