Fairytale Hair L.l.c
NPI #1851857189 in Jacksonville, Arkansas
Provider Information
- NPI Number
- 1851857189
- Entity Type
- Organization
- Organization Name
- Fairytale Hair L.l.c
- Primary Specialty
- Specialist - Prosthetics Case Management
- Enumeration Date
- Feb 12, 2019
- Last Updated
- Feb 12, 2019
Practice Location
- Address
- 1802 S HIGHWAY 161
- City
- Jacksonville
- State
- Arkansas
- ZIP Code
- 72076-5511
- Phone
- (501) 605-3405
Authorized Official
- Name
- BREANNA RICHARDSON
- Title
- OWNER
- Phone
- (501) 650-3405
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist - Prosthetics Case Management — Prosthetics Case Management |
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