Provider Demographics
NPI:1760217699
Name:MORRIS &QUOW NON-SURGICAL HAIR REPLACEMENT CLINIC, LLC
Entity type:Organization
Organization Name:MORRIS &QUOW NON-SURGICAL HAIR REPLACEMENT CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUMUMBA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUOW
Authorized Official - Suffix:
Authorized Official - Credentials:DPB
Authorized Official - Phone:910-709-8624
Mailing Address - Street 1:1019 HOPE MILLS RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4234
Mailing Address - Country:US
Mailing Address - Phone:910-485-3111
Mailing Address - Fax:
Practice Address - Street 1:1019 HOPE MILLS RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4234
Practice Address - Country:US
Practice Address - Phone:910-485-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-02
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty