Individual
GARY WOLFGANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
573 BROOKOVER AVE, ZANESVILLE, OH 43701-2101
(740) 454-0366
(740) 454-3790
Mailing address
573 BROOKOVER AVE, ZANESVILLE, OH 43701-2101
(740) 454-0366
(740) 454-3790
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000249349
ANTHEM
OH
01
—
Y281337
HEALTHPLAN
OH
Enumeration date
12/15/2006
Last updated
07/08/2007
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