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Individual

MR. DONALD S WIGGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LDO

Contact information

Practice address
7771 ASHTON AVE, MANASSAS, VA 20109-2879
(571) 393-1443
(571) 406-5043
Mailing address
8116 BETHLEHEM RD, MANASSAS, VA 20109-2704
(302) 384-3216
(571) 406-5043

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1101003676
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DWIGGS7771
VA
Enumeration date
02/10/2016
Last updated
02/10/2016
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