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NPI Profile for GREG WOMBLE in LODI, CA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pastoral |
101YP1600X | |||
Professional |
101YP2500X |
| NPI # | 1740703651 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 07/23/2017 | |
| Last updated | 07/21/2022 - About 4 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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GREG WOMBLE