Provider Demographics
NPI:1912779810
Name:MARY HAYES
Entity Type:Organization
Organization Name:MARY HAYES
Other - Org Name:THRIVING WIGS AND PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:CFM
Authorized Official - Phone:559-627-9447
Mailing Address - Street 1:1130 W MURRAY AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4718
Mailing Address - Country:US
Mailing Address - Phone:559-627-9447
Mailing Address - Fax:559-409-2981
Practice Address - Street 1:1130 W MURRAY AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4718
Practice Address - Country:US
Practice Address - Phone:559-627-9447
Practice Address - Fax:559-409-2981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty
No224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Single Specialty