| NPI Details | |
|---|---|
| NPI | 1619921137 |
| Gender | Male |
| Enumeration Date | 05/20/2006 |
| Last Updated | 07/08/2007 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 7162 RENNER RD SHAWNEE KS, 66217-9409, US |
|
| Phone | (913) 962-7770 |
| Fax | (913) 962-7775 |
| Business Location | |
|---|---|
| 7162 RENNER RD SHAWNEE KS, 66217-9409, US |
|
| Phone | (913) 962-7770 |
| Fax | (913) 962-7775 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 225100000X |
| License State | Missouri |
| License Number | R0956 |
| Remove 1619921137 NPI Number | |
According to our database, Russell A Wiglesworth P.T. NPI is 1619921137, taxonomy code is 225100000X and license number is R0956, license state is located at Missouri. Russell A Wiglesworth P.T. physically located at 7162 Renner Rd, Shawnee KS, 66217-9409. NPI Number Russell A Wiglesworth P.T. has the Individual type.
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1619921137 NPI number is provided on an as is basis without warranty of any kind. 1619921137 is maintained by the National Plan & Provider Enumeration System. The contents of Russell A Wiglesworth P.T. are for informational purposes only.
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