Individual
SETH WALTER WIETGREFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3101 LATHROP ST, FAIRBANKS, AK 99701-7426
(907) 474-0890
(907) 474-3621
Mailing address
3101 LATHROP ST, FAIRBANKS, AK 99701-7426
(907) 474-0890
(907) 474-3621
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/17/2021
Last updated
01/14/2022
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