Provider Demographics
NPI:1962124602
Name:DESIGNERS HAIR STUDIO & HAIR GROWTH CENTER
Entity type:Organization
Organization Name:DESIGNERS HAIR STUDIO & HAIR GROWTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:SPECIALIST
Authorized Official - Phone:770-633-8323
Mailing Address - Street 1:3759 MASHIE CT NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-5802
Mailing Address - Country:US
Mailing Address - Phone:770-633-8323
Mailing Address - Fax:
Practice Address - Street 1:1001 WHITLOCK AVE SW STE B
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-1971
Practice Address - Country:US
Practice Address - Phone:770-633-8323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies