Royal Glytz Hair Replacemet

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

C88537 Issued in NC

Legal business name

ROYAL GLYTZ HAIR REPLACEMET

Practice address

500 N Reilly Rd Ste 122
Fayetteville, NC 28303-2452

Phone

(910) 849-4422

NPI assigned

Feb 27, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keisha Hardaway

Title

Owner

Phone

(910) 849-4422

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1972043719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N REILLY RD STE 122",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283032452",
            "telephone_number": "910-849-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N REILLY RD STE 122",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283032452",
            "telephone_number": "910-849-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYAL GLYTZ HAIR REPLACEMET",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "HARDAWAY",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-849-4422"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NC",
            "license": "C88537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ashlee Brooke Roybal, MD

• Prosthetic/Orthotic Supplier in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Prosthetic/Orthotic Supplier in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.