Gifted Creation Restoration Hair Loss Clinic

NPI #1801492210 in Midway, Georgia

Provider Information

NPI Number: 1801492210
Entity Type: Organization
Organization Name: Gifted Creation Restoration Hair Loss Clinic
Primary Specialty: Specialist - Prosthetics Case Management
Enumeration Date: Dec 10, 2020
Last Updated: Dec 10, 2020

Practice Location

Address: 150 BUTLER ST STE D-5
City: Midway
State: Georgia
ZIP Code: 31320-4575
Phone: (912) 463-2883

Authorized Official

Name: MRS. SHONDA KING, AMCA
Title: TRICHOLOGISTS
Phone: (912) 463-2883

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X
Prosthetic/Orthotic Supplier	335E00000X
Specialist - Prosthetics Case Management — Prosthetics Case Management	1744P3200X	Primary

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James Olin Young JR., C.P.,F.A.A.O.P.	Specialist - Prosthetics Case Management	Macon	AI Deep Dive
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Cherubims Group	Specialist - Prosthetics Case Management	Marietta	AI Deep Dive

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