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General NPI Number Information
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NPI Number | 1396496691
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Entity Type | Organization
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Legal Business Name | WEAVE GOT THE LOOK, LLC
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 3949 MADDEN WAY
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City | DUMFRIES
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State | VA
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Zip | 22026-2290
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Country | US
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Telephone | 323-632-3335
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Fax |
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Provider Business Mailing Address
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Address Line | 3949 MADDEN WAY
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City | DUMFRIES
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State | VA
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Zip | 22026-2290
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Country | US
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Telephone | 323-632-3335
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | GANESA LOOK ROBINSON
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Credential |
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Telephone | 323-632-3335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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