NPI 1013362896

A Special Place Wig Boutique, LLC

Organisation Durable Medical Equipment & Medical Supplies Roanoke, VA

Practice location

Address: 5524 Williamson Rd Suite 6, Roanoke, VA 24012-1448
Phone: (540) 265-2960
Fax: (540) 265-2970

Authorised official

Name: Jamela a Hodgson
Title: Owner
Phone: (336) 574-0100

Registered specialties

Durable Medical Equipment & Medical Supplies Primary

Suppliers Taxonomy 332B00000X Licence 100033237 (VA)

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Registry record

NPI: 1013362896
Entity type: Organization
NPI issued: 28 Apr 2016
Record last updated: 28 Apr 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.