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Individual

KATE WIGMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1640 REDSTONE CENTER DR, SUITE 200, PARK CITY, UT 84098-7605
(866) 474-6677
Mailing address
1640 REDSTONE CENTER DR, SUITE 200, PARK CITY, UT 84098-7605
(866) 474-6677

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
09201
OR
225200000X
Physical Therapy Assistant
2109701
TX
225200000X
Physical Therapy Assistant
4334
ID
225200000X
Physical Therapy Assistant
Primary
5502003611
MI

Other

Enumeration date
02/15/2016
Last updated
02/15/2016
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