RYAN KENNETH WIEGAND

SPRINGFIELD, IL
NPI1447944996
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  125.082451)
Enumeration Date2023-06-07
Last Update Date2023-06-07
Business Address
RYAN KENNETH WIEGAND
520 N 4TH ST
SPRINGFIELD, IL 62702-5238
Phone number: 217-545-8000
Mailing Address
RYAN KENNETH WIEGAND
PO BOX 19670
SPRINGFIELD, IL 62794-9670
Phone number: 217-545-8000
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