Doctor Name: | MR. CHAZ LARUE WIGGINS |
NPI Number: | 1104088368 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.T. |
License Number: | 22590 |
Business Practice Address: | 117 Orville Rd Baltimore, MD - 212211309 |
Business Phone Number: | 4106862270 |
Business Fax Number: | 4106865447 |
Mailing Address: | 117 Orville Rd, BALTIMORE |
State: | MD |
Postal Code: | 212211309 |
Phone Number: | 4106862270 |
Fax Number: | 4106865447 |
NPI Enumeration Date: | 06/30/2008 |
NPI Last Update Date: | 06/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 22590 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |