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General NPI Number Information
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NPI Number | 1942489117
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Entity Type | Organization
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Legal Business Name | JEFFREY W GROLIG M D INC
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 5000 BECHELLI LN SUITE 102
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City | REDDING
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State | CA
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Zip | 96002-3553
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Country | US
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Telephone | 530-221-2520
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Fax | 530-223-2899
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Provider Business Mailing Address
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Address Line | 5000 BECHELLI LN SUITE 102
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City | REDDING
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State | CA
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Zip | 96002-3553
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Country | US
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Telephone | 530-221-2520
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Fax | 530-223-2899
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY WENDALL GROLIG
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Credential | M.D.
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Telephone | 530-221-2520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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