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Organization

BRAVADAS OF FAIRFAX LLC

Active
Other names
Bravadas wigs & Extensions
Organization subpart
No

Provider details

NPI number
Authorized official
TRACY HOBBS (VP OF OPERATIONS)
(402) 397-2524
Entity
Organization

Contact information

Practice address
11204 LEE HIGHWAY, FAIRFAX, VA 22030
(703) 352-4247
Mailing address
11204 LEE HIGHWAY, FAIRFAX, VA 22030
(703) 352-4247

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
11/04/2015
Last updated
11/04/2015
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