NPI 1073275780

29th & Glam Extensions LLC

Organisation Prosthetic/Orthotic Supplier Marietta, GA

Practice location

Address: 1250 Powder Springs St APT 2021, Marietta, GA 30064-5249
Phone: (706) 668-7657

Authorised official

Name: Shevon M Phillips
Title: Owner
Phone: (706) 668-7657

Registered specialties (3)

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X

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Customized Equipment (DME)

Suppliers Taxonomy 332BC3200X

Registry record

NPI: 1073275780
Entity type: Organization
NPI issued: 11 Oct 2021
Record last updated: 11 Oct 2021

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.