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1932739141
WALLACE T. WIGGAM
SANTA ROSA, CA
NPI
1932739141
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163WA0400X Registered Nurse, Addiction (Substance Use Disorder)
(Licence: CA 307469)
Enumeration Date
2020-01-16
Last Update Date
2020-01-16
Business Address
WALLACE T. WIGGAM RN
2403 PROFESSIONAL DR # CA
SANTA ROSA, CA 95403-3007
Phone number: 707-544-3295
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Mailing Address
WALLACE T. WIGGAM RN
2403 PROFESSIONAL DR # CA
SANTA ROSA, CA 95403-3007
Phone number: 707-544-3295
Copy
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