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Individual

DEBRA WIGGINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1310 BRADLEY DR, MOUNTAIN HOME, AR 72653-2730
(870) 424-4021
(870) 424-4112
Mailing address
174 COUNTY ROAD 710, GASSVILLE, AR 72635-8604
(870) 435-5888
(870) 424-4112

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA946
AR

Other

Enumeration date
06/20/2012
Last updated
06/20/2012
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