Individual
RONNIE WIGFALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
106 WOODY LN, EASLEY, SC 29640-8858
(864) 325-3894
Mailing address
106 WOODY LN, EASLEY, SC 29640-8858
(864) 325-3894
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
111266264
SC
Other
Enumeration date
10/20/2017
Last updated
10/20/2017
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