Organization
JEFFREY W GROLIG M D INC
Active
Parent organization
JEFFREY W GROLIG M D INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JEFFREY W GROLIG M D INC
Authorized official
DR. JEFFREY WENDALL GROLIG M.D. (OWNER)
(530) 221-2520
Entity
Organization
Contact information
Practice address
5000 BECHELLI LN, SUITE 102, REDDING, CA 96002-3553
(530) 221-2520
(530) 223-2899
Mailing address
5000 BECHELLI LN, SUITE 102, REDDING, CA 96002-3553
(530) 221-2520
(530) 223-2899
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C414610
—
CA
01
—
171374100
DEPT OF LABOR PROVIDERS #
CA
01
—
41461
DEPT OF LABOR PROVIDERS #
WA
Enumeration date
10/24/2007
Last updated
04/30/2008
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