Provider Demographics
NPI:1184382970
Name:THE B. DAVIS HAIR CARE SALON INC
Entity type:Organization
Organization Name:THE B. DAVIS HAIR CARE SALON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:GENETTE
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:HAIR LOSS SPECIALIST
Authorized Official - Phone:463-224-7952
Mailing Address - Street 1:5401 S EAST ST STE 107
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-2076
Mailing Address - Country:US
Mailing Address - Phone:463-224-7952
Mailing Address - Fax:317-757-6101
Practice Address - Street 1:5401 S EAST ST STE 107
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-2076
Practice Address - Country:US
Practice Address - Phone:463-224-7952
Practice Address - Fax:317-757-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty