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General NPI Number Information
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NPI Number | 1942490784
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Entity Type | Organization
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Legal Business Name | HI FASHION WIGS LLC
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 1133 NORTH MAY AVE. SS
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City | OKLAHOMA CITY
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State | OK
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Zip | 73107-5335
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Country | US
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Telephone | 405-942-0884
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Fax |
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Provider Business Mailing Address
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Address Line | 1133 N MAY AVE # SS
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City | OKLAHOMA CITY
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State | OK
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Zip | 73107-5335
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Country | US
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Telephone | 405-942-0884
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. CELINA CLAY
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Credential |
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Telephone | 405-942-0884
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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 | 242128
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License Number State | OK
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