Provider Demographics
NPI:1104378298
Name:LUXE STUDIO LLC
Entity Type:Organization
Organization Name:LUXE STUDIO LLC
Other - Org Name:LUXE STUDIO BY MONICA JONES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-554-9472
Mailing Address - Street 1:22064 HIGHVIEW TRAIL PL
Mailing Address - Street 2:
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4564
Mailing Address - Country:US
Mailing Address - Phone:703-554-9472
Mailing Address - Fax:
Practice Address - Street 1:22064 HIGHVIEW TRAIL PL
Practice Address - Street 2:
Practice Address - City:BROADLANDS
Practice Address - State:VA
Practice Address - Zip Code:20148-4564
Practice Address - Country:US
Practice Address - Phone:703-554-9472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1744P3200XOtherTAXONOMY