Individual
MRS. SHADERA WIGINTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3801 24TH AVE SE APT 12, NORMAN, OK 73071-0800
(405) 596-7148
Mailing address
3801 24TH AVE SE APT 12, NORMAN, OK 73071-0800
(405) 596-7148
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1417
OK
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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