Organization
THE WIG RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATAJA MARSHALL (OWNER)
(318) 840-9447
Entity
Organization
Contact information
Practice address
3309 WILLIAMSBURG PL, BOSSIER CITY, LA 71112
(318) 840-9447
Mailing address
3309 WILLIAMSBURG PL, BOSSIER CITY, LA 71112
(318) 840-9447
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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