# WIG RX LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033091376
- **Authorized official:** AMANDA EVANS OWNER/COSMETOLOGIST (CRANIAL PROSTHESIS PROVIDER)
- **Authorized official phone:** (860) 222-5513

## Contact information

- **Practice address:** 256 BOSTON POST RD., WATERFORD, CT 06385
- **Practice address phone:** (860) 222-5513
- **Mailing address:** 292 S FRONTAGE RD \# 1036, NEW LONDON, CT 06320-2641
- **Mailing address phone:** (860) 222-5513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 07/25/2025
- **Last updated:** 07/26/2025