Individual
CHARLETTE SHY WIGGINS-GURICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3161 WALNUT AVE, FREMONT, CA 94538-2216
(510) 796-1000
Mailing address
573 SE WALNUT ST APT 1, HILLSBORO, OR 97123-4441
(408) 841-1493
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
64122
OR
Other
Enumeration date
06/11/2021
Last updated
06/11/2021
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