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Individual

DR. ERICKA D WIGFALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
100 SPRING HARBOR DR, COLUMBUS, GA 31904-4619
(706) 576-6000
Mailing address
609 OLD WHEAT ST NE, ATLANTA, GA 30312-1926
(615) 423-8001

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT010312
GA
225100000X
Physical Therapist
PT29913
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT010312
GEORGIA STATE BOARD OF PHYSICAL THERAPY
GA
01
PT29913
FLORIDA STATE BOARD OF PHYSICAL THERAPY
FL
Enumeration date
10/07/2015
Last updated
10/07/2015
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