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1447944996
RYAN KENNETH WIEGAND
SPRINGFIELD, IL
NPI
1447944996
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 125.082451)
Enumeration Date
2023-06-07
Last Update Date
2023-06-07
Business Address
RYAN KENNETH WIEGAND
520 N 4TH ST
SPRINGFIELD, IL 62702-5238
Phone number: 217-545-8000
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Mailing Address
RYAN KENNETH WIEGAND
PO BOX 19670
SPRINGFIELD, IL 62794-9670
Phone number: 217-545-8000
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