Provider Demographics
NPI:1720529514
Name:LOVELY HAIR SOLUTIONS
Entity type:Organization
Organization Name:LOVELY HAIR SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HAIR LOSS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:BRASWELL
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:TRICHOLOGIST
Authorized Official - Phone:203-676-4982
Mailing Address - Street 1:PO BOX 1142
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27894-1142
Mailing Address - Country:US
Mailing Address - Phone:203-676-4982
Mailing Address - Fax:
Practice Address - Street 1:4701 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-8108
Practice Address - Country:US
Practice Address - Phone:252-205-6767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC30180335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier