Healthcare Provider Details

I. General information

NPI: 1053235168
Provider Name (Legal Business Name): GIVEN CONFIDENCE MEDICAL WIGS & CRANIAL PROSTHESES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3519 IBERIS LN
TOANO VA
23168-9553
US

IV. Provider business mailing address

3519 IBERIS LN
TOANO VA
23168-9553
US

V. Phone/Fax

Practice location:
  • Phone: 948-228-7209
  • Fax:
Mailing address:
  • Phone: 948-228-7209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: LATONYA BLOW
Title or Position: CEO
Credential:
Phone: 948-228-7209