Most Relevant Information
Provider Data
| NPI Number: | 1003520677 |
| Provider Name: | COURTNEY WIGGINS |
| Entity Type: | Individual |
| Taxonomy Code: | 310400000X |
| Specialty: | Assisted Living Facility |
| License Number: | AL-00114 |
Most Important Dates
| Enumeration Date: | 01/09/2023 |
| Last Updated: | 01/09/2023 |
Provider Practice Location
3200 ECHODALE AVE
BALTIMORE
MD
212142619
Practice Location Phone/Fax
| Phone: | 2028702916 |
| Fax: |
Provider Mailing Location
3200 ECHODALE AVE
BALTIMORE
MD
212142619
Provider Mailing Phone/Fax
| Phone: | 2028702916 |
| Fax: |