| NPI | 1912444712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEVONDA NICOLE EVANS Owner/Esthetician 907-433-9529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: SC 78135) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2017-01-31 |