Organization
WIG RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA EVANS OWNER/COSMETOLOGIST (CRANIAL PROSTHESIS PROVIDER)
(860) 222-5513
Entity
Organization
Contact information
Practice address
256 BOSTON POST RD., WATERFORD, CT 06385
(860) 222-5513
Mailing address
292 S FRONTAGE RD # 1036, NEW LONDON, CT 06320-2641
(860) 222-5513
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/25/2025
Last updated
07/26/2025
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