NPI 1053657924

Jazz Hair Institute

Organisation Prosthetist Saint Louis, MO

Practice location

Address: 3950 Cook Ave, Saint Louis, MO 63113-3402
Phone: (314) 258-7061
Mailing address: 3950 Cook Ave, Saint Louis, MO 63113

Authorised official

Name: Kelley Jordan
Title: Cosmetologist
Phone: (314) 389-5770

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Registry record

NPI: 1053657924
Entity type: Organization
NPI issued: 21 Dec 2012
Record last updated: 20 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.