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General NPI Number Information
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NPI Number | 1033022116
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Entity Type | Organization
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Legal Business Name | J HAIR PROSTHETICS & RESTORATION LLC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 1605 BENTON RD STE M2
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City | BOSSIER CITY
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State | LA
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Zip | 71111-3580
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Country | US
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Telephone | 337-292-6029
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Fax |
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Provider Business Mailing Address
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Address Line | 5144 TARA LN
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City | BOSSIER CITY
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State | LA
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Zip | 71111-7809
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Country | US
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Telephone | 337-292-6029
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | JUSTINA OSIFO
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Credential |
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Telephone | 337-292-6029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | NULL
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