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General NPI Number Information
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NPI Number | 1366181794
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Entity Type | Organization
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Legal Business Name | MEDICAL WIGS BY JOJO LLC
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 1830 E AVENUE J2 APT 7
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City | LANCASTER
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State | CA
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Zip | 93535-4434
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Country | US
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Telephone | 661-480-3703
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Fax |
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Provider Business Mailing Address
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Address Line | 1830 E AVENUE J2 APT 7
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City | LANCASTER
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State | CA
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Zip | 93535-4434
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Country | US
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Telephone | 661-480-3703
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Fax |
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Authorized Official
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Title or Position | CRANIAL PROSTHESIS SPECIALIST
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Name | MS. JOANN HARRIS
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Credential |
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Telephone | 661-480-3703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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