Brandis Wig Salon

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

BRANDIS WIG SALON

Practice address

7275 103Rd St
Jacksonville, FL 32210

Phone

(904) 771-7355

Fax

(904) 772-8316

NPI assigned

Nov 20, 2008

Last updated

Nov 20, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Brenda K Connor

Title

Owner/President

Phone

(904) 771-7355

Specialties & licenses 1

Addresses

Other names 1

• Brandis Hair Company DBA Brandis Wig Salon Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1760637599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7275 103RD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32210",
            "telephone_number": "904-771-7355",
            "fax_number": "904-772-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7275 103RD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32210",
            "telephone_number": "904-771-7355",
            "fax_number": "904-772-8316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDIS WIG SALON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "CONNOR",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "904-771-7355",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brandis Hair Company DBA Brandis Wig Salon",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Tiffany Branch, OT
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• Shannon M Brandes, CRNA
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• Nathan Brandon

• Prosthetic/Orthotic Supplier in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.