Organization
BUILD-A-WIG
Active
Parent organization
BUILD-A-WIG
Organization subpart
Yes
Provider details
NPI number
Legal business name
BUILD-A-WIG
Authorized official
JERICA LAFAYETTE (OWNER)
(225) 223-8053
Entity
Organization
Contact information
Practice address
149 CORA DR, BATON ROUGE, LA 70815-4202
(225) 223-8053
Mailing address
9442 COUNTRY LAKE DR, BATON ROUGE, LA 70817-7027
(225) 223-8053
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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