Provider Demographics
NPI:1992588164
Name:THE HAIR TOSS BOSS AND COMPANY
Entity type:Organization
Organization Name:THE HAIR TOSS BOSS AND COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSTHETIC WIG SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ARCHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-663-7237
Mailing Address - Street 1:312 W MCKINLEY RD
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:IL
Mailing Address - Zip Code:61350-4717
Mailing Address - Country:US
Mailing Address - Phone:815-663-7237
Mailing Address - Fax:
Practice Address - Street 1:312 W MCKINLEY RD
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-4717
Practice Address - Country:US
Practice Address - Phone:815-663-7237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier