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Organization

DIABETES AND WEIGHT MANAGEMENT RX

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAWNA WIGLE NP (AUTHORIZED OFFICIAL/ OWNER)
(919) 475-5665
Entity
Organization

Contact information

Practice address
32 SOUTH ST STE 301A, WALTHAM, MA 02453-3525
(919) 475-5665
Mailing address
10 LEBLANC LN, WALTHAM, MA 02452-0316
(919) 475-5665

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
09/01/2023
Last updated
11/15/2023
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