Individual
LAURA W WIEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
9516 CRAIGS MILL DR, GLEN ALLEN, VA 23060-3555
(804) 965-6232
(804) 545-2806
Mailing address
3805 CUTSHAW AVE, SUITE 299, RICHMOND, VA 23230
(804) 340-1193
(804) 340-1930
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305005661
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15291354
AETNA
—
01
—
183531
ANTHEM PPO
—
01
—
183574
ANTHEM PPO
—
01
—
255534
SOUTHERN HEALTH
—
01
—
329180
MAMSI
—
01
—
429180
MAMSI
—
01
—
54960
MEDICAID HMO
—
01
—
6400713
UNITED HEALTHCARE
—
01
—
6404543
UNITED HEALTHCARE
—
Enumeration date
04/12/2006
Last updated
01/17/2008
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