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General NPI Number Information
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NPI Number | 1356211783
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Entity Type | Individual
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Provider Name | JUSTIN DAIN HIGGINS
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Gender | Male
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Dates
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Enumeration Date | 11/10/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 508 S OSBORNE AVE
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City | GILLETTE
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State | WY
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Zip | 82716-4351
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Country | US
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Telephone | 479-326-2176
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Fax | 479-326-2176
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Provider Business Mailing Address
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Address Line | 3905 S COLLEGE PARK CT
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City | GILLETTE
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State | WY
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Zip | 82718-9441
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Country | US
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Telephone | 479-326-2176
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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