1245959550 NPI number — UNIQUE HAIR & SCALP CLINIC LLC

Table of content: DR. NATHANAEL PAUL KLINE D.C. (NPI 1821545195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245959550 NPI number — UNIQUE HAIR & SCALP CLINIC LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIQUE HAIR & SCALP CLINIC LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245959550
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
58 PARKERS DR # 302
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOVER
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19904-1465
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-331-8872
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1188 FORREST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOVER
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19904-3379
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-566-7144
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/22/2022

Additional Information

Authorized Official

Authorized Official Last Name:
WHITE-BLOUNT
Authorized Official First Name:
VELMA
Authorized Official Middle Name:
REE
Authorized Official Title or Position:
TRICOLOGIST
Authorized Official Telephone Number:
302-331-8872

Provider Taxonomy Codes

  • Taxonomy code: 1744P3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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