Provider Demographics
NPI:1134006737
Name:LOVELY MEDICAL WIGS LLC
Entity type:Organization
Organization Name:LOVELY MEDICAL WIGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-291-7272
Mailing Address - Street 1:3519 IBERIS LN
Mailing Address - Street 2:
Mailing Address - City:TOANO
Mailing Address - State:VA
Mailing Address - Zip Code:23168-9553
Mailing Address - Country:US
Mailing Address - Phone:757-291-7272
Mailing Address - Fax:757-291-7272
Practice Address - Street 1:3519 IBERIS LN
Practice Address - Street 2:
Practice Address - City:TOANO
Practice Address - State:VA
Practice Address - Zip Code:23168-9553
Practice Address - Country:US
Practice Address - Phone:757-291-7272
Practice Address - Fax:757-291-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty