Individual
DR. KYLE GLENN WIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD, MBA
Contact information
Practice address
1979 LIME KILN RD, GREEN BAY, WI 54311-6219
(920) 288-0638
Mailing address
803 FREDRICK CT APT 3, GREEN BAY, WI 54313-7994
(304) 893-8239
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19615-40
WI
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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