Provider Demographics
NPI:1538816533
Name:TOTAL IMAGE WIGS AND HAIR RESTORATION
Entity type:Organization
Organization Name:TOTAL IMAGE WIGS AND HAIR RESTORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EDNA (NEISE)
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-350-4870
Mailing Address - Street 1:5550 TOPANGA CANYON BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367
Mailing Address - Country:US
Mailing Address - Phone:818-350-4870
Mailing Address - Fax:213-556-1751
Practice Address - Street 1:5550 TOPANGA CANYON BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367
Practice Address - Country:US
Practice Address - Phone:818-350-4870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies