Individual
KIM CHERI WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
738 N COLLEGE RD, SUITE C, TWIN FALLS, ID 83301-3385
(208) 814-7100
(208) 737-2731
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
M9039
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962419770
—
ID
01
—
P00899548
MCRR
ID
Enumeration date
08/02/2006
Last updated
01/03/2014
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