Wiggam, Wallace T.

Wiggam, Wallace T. is an individual health care provider with primary practice located at 2403 Professional Dr # Ca , Santa Rosa CA 95403-3007. He recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Wiggam, Wallace T. can be contacted via phone (707) 544-3295.

Contact Information

Primary practice address
2403 Professional Dr # Ca Santa Rosa CA 95403-3007
Phone: (707) 544-3295
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Addiction (Substance Use Disorder) 163WA0400X 307469 California

Profile Details

NPI number 1932739141
LBN Legal business name Wiggam, Wallace T.
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2020
Last updated Jan 16th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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