Provider Demographics
NPI:1710120563
Name:WRAYCON, LLC
Entity Type:Organization
Organization Name:WRAYCON, LLC
Other - Org Name:ASPEN FENCE & DECK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:WRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-470-1391
Mailing Address - Street 1:PO BOX 285
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20168-0285
Mailing Address - Country:US
Mailing Address - Phone:703-470-1391
Mailing Address - Fax:
Practice Address - Street 1:4505 MARTINWOOD DR
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-2208
Practice Address - Country:US
Practice Address - Phone:703-470-1391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705117776171W00000X, 171WH0202X, 171WV0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
No171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Single Specialty