Provider Demographics
NPI:1861105637
Name:ONYX & MANE CUSTOMS LLC
Entity type:Organization
Organization Name:ONYX & MANE CUSTOMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASTER COSMOTOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PAISLEY
Authorized Official - Suffix:
Authorized Official - Credentials:SPECIALIST
Authorized Official - Phone:954-305-4061
Mailing Address - Street 1:2852 DEANS BRIDGE RD STE C
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-2767
Mailing Address - Country:US
Mailing Address - Phone:954-305-4061
Mailing Address - Fax:
Practice Address - Street 1:2852 DEANS BRIDGE RD STE C
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-2767
Practice Address - Country:US
Practice Address - Phone:954-305-4061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty