MEDICARE: DAVID L. WIGTON D.C. INC

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	261Q00000X	Clinic/Center	1015	OH

General Provider Information

NPI Number	:	1720320674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID L. WIGTON D.C. INC

Provider Business Mailing Address
First Line	:	922 E COLUMBUS ST
Second Line	:
City	:	KENTON
State	:	OH
Zip	:	43326-1683
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	922 E COLUMBUS ST
Second Line	:
City	:	KENTON
State	:	OH
Zip	:	43326-1683
Country	:	US
Telephone Number	:	419-673-3111
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID WIGTON
Credential	:	D.C.
Telephone Number	:	419-673-3111

Provider Enumeration Date	:	03/19/2013
Last Update Date	:	03/19/2013

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