Organization
WESTERN CAROLINA O & P
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY WIGGEN COF (PRACTICE MANAGER)
(828) 595-9371
Entity
Organization
Contact information
Practice address
107 E WALKER ST, EAST FLAT ROCK, NC 28726-2235
(828) 595-9371
(828) 595-9373
Mailing address
107 EAST WALKER STREET, EAST FLAT ROCK, NC 28726
(828) 595-9371
(828) 595-9373
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7200591
—
NC
Enumeration date
11/26/2012
Last updated
08/27/2014
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