ED J. WIGG

JACKSON, WY
NPI1154647105
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WY  LAT017)
Enumeration Date2010-04-15
Last Update Date2010-04-15
Business Address
-- ED J. WIGG
610 W. BROADWAY SUITE L1
JACKSON, WY 83002
Phone number: 307-733-3908
Mailing Address
-- ED J. WIGG
PO BOX 11390
JACKSON, WY 83002-1390
Phone number: 307-733-3908
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