Doctor Name: | DR. GEORGE RILEY WREGGIT |
NPI Number: | 1629484480 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 12525 |
Business Practice Address: | 851 Doe Run Rd Sequim, WA - 983823804 |
Business Phone Number: | 3606831904 |
Business Fax Number: | |
Mailing Address: | 851 Doe Run Rd, SEQUIM |
State: | WA |
Postal Code: | 983823804 |
Phone Number: | 3606831904 |
Fax Number: | |
NPI Enumeration Date: | 07/01/2014 |
NPI Last Update Date: | 07/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 12525 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |