Individual
DOMINIQUE WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2710 N HARBOR DR, SAN DIEGO, CA 92101-1028
(619) 278-7134
Mailing address
2710 N HARBOR DR, SAN DIEGO, CA 92101-1028
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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