Provider Demographics
NPI:1063188423
Name:MAKIN CHANGEZ SALON
Entity type:Organization
Organization Name:MAKIN CHANGEZ SALON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SALON OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:P
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-704-9665
Mailing Address - Street 1:10855 W PARK PL
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-3600
Mailing Address - Country:US
Mailing Address - Phone:414-704-9665
Mailing Address - Fax:
Practice Address - Street 1:10855 W PARK PL
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-3600
Practice Address - Country:US
Practice Address - Phone:414-704-9665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty