Organization
BRAVADAS OF FAIRFAX LLC
Active
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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