Organization
WESTERN CAROLINA O & P
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY ROBERTS WIGGEN COF (MANAGER)
(828) 595-9371
Entity
Organization
Contact information
Practice address
366 S PINE ST, SPARTANBURG, SC 29302-2624
(864) 208-1745
(864) 208-1778
Mailing address
107 E WALKER ST, EAST FLAT ROCK, NC 28726-2235
(828) 595-9371
(828) 595-9373
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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