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General NPI Number Information
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NPI Number | 1275002842
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Entity Type | Organization
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Legal Business Name | HAUTE HAIR WIGS AND EXTENSIONS LLC
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 11/13/2018
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Provider Practice Location Address
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Address Line | 820 H ST NE STE A
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City | WASHINGTON
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State | DC
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Zip | 20002-3662
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Country | US
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Telephone | 202-543-1090
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Fax | 888-395-0772
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Provider Business Mailing Address
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Address Line | 820 H ST NE STE A
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City | WASHINGTON
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State | DC
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Zip | 20002-3662
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Country | US
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Telephone | 202-543-1090
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Fax | 888-395-0772
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MIA COLLEEN STEWART
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Credential |
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Telephone | 202-957-1331
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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 |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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