MEDICARE: WC HAIR RESTORATION & PROSTHETICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1306791645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WC HAIR RESTORATION & PROSTHETICS LLC

Provider Business Mailing Address
First Line	:	5505 MAIN ST STE 104
Second Line	:
City	:	DEL CITY
State	:	OK
Zip	:	73115-5508
Country	:	US
Telephone Number	:	405-496-7298
Fax Number	:

Provider Business Practice Location Address
First Line	:	5505 MAIN ST STE 104
Second Line	:
City	:	DEL CITY
State	:	OK
Zip	:	73115-5508
Country	:	US
Telephone Number	:	405-496-7298
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ MANAGING MEMBER
Name	:	MRS. WINNIE CHANEL LAWRENCE
Credential	:
Telephone Number	:	405-496-7298

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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