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NPI Code Detail

MEDICARE: MR. BRIAN LYNN WIGGEN II II CO. BOCO

MEDICARE:  MR. BRIAN LYNN WIGGEN II II CO. BOCO
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
1224P00000XProsthetistNC
2222Z00000XOrthotistNC

General Provider Information

NPI Number : 1821266230
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN LYNN WIGGEN II II CO. BOCO
Provider Business Mailing Address
First Line : 107 EAST WALKER ST.
Second Line :
City : EAST FLAT ROCK
State : NC
Zip : 28726
Country : US
Telephone Number : 828-595-9371
Fax Number : 828-595-9373
Provider Business Practice Location Address
First Line : 107 EAST WALKER ST
Second Line :
City : EAST FLAT ROCK
State : NC
Zip : 28726
Country : US
Telephone Number : 828-595-9371
Fax Number : 828-595-9373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2008
Last Update Date : 10/17/2024

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Directions to “ MR. BRIAN LYNN WIGGEN II II CO. BOCO” Practice Location

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