NPI 1073239265

Ian Bradley Hair Salon LLC

Organisation Prosthetic/Orthotic Supplier Macon, GA

Practice location

Address: 3902 Northside Dr STE A3, Macon, GA 31210-2459
Phone: (478) 845-1210
Fax: (478) 210-5078
Mailing address: 222 Joycliff Cir, Macon, GA 31211-7040

Authorised official

Name: Melissa R McCoy
Title: Owner
Phone: (478) 714-4302

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

Other Prosthetic/Orthotic Supplier providers in Georgia →

Registry record

NPI: 1073239265
Entity type: Organization
NPI issued: 18 Oct 2022
Record last updated: 18 Oct 2022

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.