Provider Demographics
NPI:1699137224
Name:TRULY BEAUTIFUL
Entity type:Organization
Organization Name:TRULY BEAUTIFUL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED HAIR LOSS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:STURDIVANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-401-7312
Mailing Address - Street 1:PO BOX 9715
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35220-0715
Mailing Address - Country:US
Mailing Address - Phone:205-401-7312
Mailing Address - Fax:
Practice Address - Street 1:1609 1ST ST NE
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:AL
Practice Address - Zip Code:35215-5603
Practice Address - Country:US
Practice Address - Phone:205-401-7312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRULY BEAUTIFUL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty