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Individual
LORI JEANNE WIGLEY
Active
Individual
LORI JEANNE WIGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
294206
CA
225100000X
Physical Therapist
3341
OR
225100000X
Physical Therapist
PT00010169
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022414003
REGENCE BLUECROSS/BLUESHE
OR
Enumeration date
10/23/2006
Last updated
11/19/2018
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