WALLACE T. WIGGAM

SANTA ROSA, CA
NPI1932739141
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy163WA0400X Registered Nurse, Addiction (Substance Use Disorder)
(Licence: CA  307469)
Enumeration Date2020-01-16
Last Update Date2020-01-16
Business Address
WALLACE T. WIGGAM RN
2403 PROFESSIONAL DR # CA
SANTA ROSA, CA 95403-3007
Phone number: 707-544-3295
Mailing Address
WALLACE T. WIGGAM RN
2403 PROFESSIONAL DR # CA
SANTA ROSA, CA 95403-3007
Phone number: 707-544-3295