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950 48th Ave N Ste 101, Myrtle Beach, SC 29577-5434 | |
(843) 491-9008 | |
(843) 491-9009 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Hearing And Speech |
Location | 950 48th Ave N Ste 101, Myrtle Beach, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1295409662 | NPI | - | NPPES |
Provider Name | Jason Paul Wigand |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1205247772 PECOS PAC ID: 5698091098 Enrollment ID: I20150303001594 |
Mailing Address | Practice Location Address |
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950 48th Ave N Ste 101, Myrtle Beach, SC 29577-5434 Ph: (843) 491-9008 | 950 48th Ave N Ste 101, Myrtle Beach, SC 29577-5434 Ph: (843) 491-9008 |