Organization
OT WIGS & EXTENSIONS DESIGN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLIVIA TYRA (OWNER)
(703) 313-1930
Entity
Organization
Contact information
Practice address
8607 WESTWOOD CENTER DR STE 7, VIENNA, VA 22182-7506
(703) 313-1930
Mailing address
8607 WESTWOOD CENTER DR STE 7, VIENNA, VA 22182-7506
(703) 313-1930
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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