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General NPI Number Information
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NPI Number | 1922969328
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Entity Type | Individual
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Provider Name | LEVI WIGGINS
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Gender | Male
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 2150 LEXINGTON RD STE A&B
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City | RICHMOND
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State | KY
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Zip | 40475-7924
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Country | US
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Telephone | 859-353-5445
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Fax | 859-353-5601
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Provider Business Mailing Address
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Address Line | 2150 LEXINGTON RD STE A&B
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City | RICHMOND
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State | KY
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Zip | 40475-7924
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Country | US
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Telephone | 859-353-5445
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Fax | 859-353-5601
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 009507
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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