Provider Demographics
NPI:1477812287
Name:SOHO HAIR AND WIGS
Entity Type:Organization
Organization Name:SOHO HAIR AND WIGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-735-9494
Mailing Address - Street 1:755 BIELENBERG DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4433
Mailing Address - Country:US
Mailing Address - Phone:651-735-9494
Mailing Address - Fax:
Practice Address - Street 1:755 BIELENBERG DR
Practice Address - Street 2:SUITE 104
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4433
Practice Address - Country:US
Practice Address - Phone:651-735-9494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies