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NPI 1073275780

OrganizationActive

29th & Glam Extensions LLC

NPI 1073275780 · Prosthetic/Orthotic Supplier · Marietta, GA

Provider details

NPI number: 1073275780
Entity type: Organization
Primary specialty: Prosthetic/Orthotic SupplierSuppliers
Authorized official: Shevon Phillips, Owner

Practice location

1250 Powder Springs St Apt 2021

Marietta, GA 30064-5249

Phone: (706) 668-7657

More GA providers

Mailing address

1250 Powder Springs St Apt 2021

Marietta, GA 30064-5249

Registry dates

Enumerated: 2021-10-11
Last updated: 2021-10-11

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

29th & Glam Extensions LLC — NPI 1073275780, Marietta, GA | NPI Central