# MEDICAL WIG SPECIALIST LLC

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

## Provider details

- **NPI number:** 1306750021
- **Authorized official:** TENITA PARKER (OWNER)
- **Authorized official phone:** (661) 714-4665

## Contact information

- **Practice address:** 2056 E 3300 S, MILLCREEK, UT 84109-2665
- **Practice address phone:** (385) 202-4622
- **Mailing address:** 2056 E 3300 S, MILLCREEK, UT 84109-2665
- **Mailing address phone:** (661) 714-4665

## Taxonomy

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

## Other

- **Enumeration date:** 09/30/2026
- **Last updated:** 09/30/2026