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Individual

MRS. APRIL LYNN WIGLEY-ELLIOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
119 N BROADWAY AVE STE 10, ADA, OK 74820
(580) 235-8047
Mailing address
4316 TRINITY DR, SHAWNEE, OK 74804-8965
(580) 235-8047

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
172582
OK
225700000X
Massage Therapist
MT103888
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
172582
OK STATE BOARD OF COSMETOLOGY
OK
01
MT103888
STATE OF TEXAS
TX
Enumeration date
04/05/2013
Last updated
05/21/2019
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