Provider Demographics
NPI:1528420221
Name:WHY KNOT HAIR SALON
Entity type:Organization
Organization Name:WHY KNOT HAIR SALON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED HAIR LOSS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLINKSCALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-261-2553
Mailing Address - Street 1:915 BINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-2841
Mailing Address - Country:US
Mailing Address - Phone:910-323-5668
Mailing Address - Fax:
Practice Address - Street 1:915 BINGHAM DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-2841
Practice Address - Country:US
Practice Address - Phone:910-323-5668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty