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General NPI Number Information
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NPI Number | 1003403346
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Entity Type | Individual
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Provider Name | DEB RIGGOTT
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Gender | Female
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Dates
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Enumeration Date | 12/21/2020
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 390 LINCOLN RD
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City | SUDBURY
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State | MA
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Zip | 01776-1409
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Country | US
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Telephone | 508-451-2730
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Fax |
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Provider Business Mailing Address
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Address Line | 1 STONE HILL TER
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City | WALPOLE
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State | MA
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Zip | 02081-2612
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Country | US
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Telephone | 508-451-2730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | AT-306
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License Number State | MA
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