Provider Demographics
NPI:1366181794
Name:MEDICAL WIGS BY JOJO LLC
Entity type:Organization
Organization Name:MEDICAL WIGS BY JOJO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CRANIAL PROSTHESIS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-480-3703
Mailing Address - Street 1:1830 E AVENUE J2 APT 7
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-4434
Mailing Address - Country:US
Mailing Address - Phone:661-480-3703
Mailing Address - Fax:
Practice Address - Street 1:1830 E AVENUE J2 APT 7
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-4434
Practice Address - Country:US
Practice Address - Phone:661-480-3703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty