Provider Demographics
NPI:1528450160
Name:HAIRBOTICS, LLC
Entity type:Organization
Organization Name:HAIRBOTICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TRICHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AFANSO
Authorized Official - Middle Name:BOBBY
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:TRICHOLOGIST
Authorized Official - Phone:703-496-6083
Mailing Address - Street 1:8807 SUDLEY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4738
Mailing Address - Country:US
Mailing Address - Phone:571-208-0146
Mailing Address - Fax:
Practice Address - Street 1:8807 SUDLEY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4738
Practice Address - Country:US
Practice Address - Phone:571-208-0146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1261001419335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier