Individual
SHELLEY ANITA WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
560 LEBO BLVD, BREMERTON, WA 98310-2617
(360) 479-1515
Mailing address
560 LEBO BLVD, BREMERTON, WA 98310-2617
(360) 479-1515
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160033195
WA
Other
Enumeration date
03/16/2015
Last updated
03/16/2015
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