Individual
MICHELLE RAE WIGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7108 HEARTHSTONE RD NW, ALBUQUERQUE, NM 87114-4583
(210) 275-9968
Mailing address
7108 HEARTHSTONE RD NW, ALBUQUERQUE, NM 87114-4583
(210) 275-9968
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-0962
NM
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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