Provider Demographics
NPI:1528450228
Name:WEDGLE, TOBY (LAC)
Entity type:Individual
Prefix:
First Name:TOBY
Middle Name:
Last Name:WEDGLE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:TOBY
Other - Middle Name:
Other - Last Name:HELMSTETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:907 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4141
Mailing Address - Country:US
Mailing Address - Phone:919-286-9595
Mailing Address - Fax:919-286-2425
Practice Address - Street 1:907 BROAD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4141
Practice Address - Country:US
Practice Address - Phone:919-286-9595
Practice Address - Fax:919-286-2425
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC283171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist