MEDICARE: BARBARA WIGGINS MOT, OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	1595	AK

General Provider Information

NPI Number	:	1356677470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA WIGGINS MOT, OTR

Provider Business Mailing Address
First Line	:	10048 EXPEDITION CIR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99515-2438
Country	:	US
Telephone Number	:	907-868-1577
Fax Number	:

Provider Business Practice Location Address
First Line	:	10048 EXPEDITION CIR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99515-2438
Country	:	US
Telephone Number	:	907-868-1577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2009
Last Update Date	:	10/23/2009

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