Individual
MS. RITA LOVACIA WIGGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
915 N GRAND BLVD, 11FJC, SAINT LOUIS, MO 63106-1621
(314) 652-4100
(314) 289-6478
Mailing address
1721 S 18TH ST, SAINT LOUIS, MO 63104-3401
(314) 771-6065
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
112061
MO
Other
Enumeration date
04/07/2006
Last updated
07/08/2007
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