Individual
MR. GREGORY RICHARD WIEGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1665 M ST, FRESNO, CA 93721-1121
(559) 268-5361
Mailing address
1665 M ST, FRESNO, CA 93721-1121
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
48456
CA
Other
Enumeration date
01/27/2019
Last updated
01/27/2019
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