Bedazzled Salon and Spa

NPI #1124309919 in Roscoe, Illinois

Provider Information

NPI Number: 1124309919
Entity Type: Organization
Organization Name: Bedazzled Salon and Spa
Primary Specialty: Specialist
Enumeration Date: Sep 7, 2011
Last Updated: Sep 7, 2011

Practice Location

Address: 11708 MAIN ST
City: Roscoe
State: Illinois
ZIP Code: 61073-9566
Phone: (815) 389-4965

Authorized Official

Name: ANTHONY JENKINS
Title: OWNER
Phone: (815) 389-4965

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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