Walter Rudolph Wiesztort D.C.

NPI 1003814336 - Chiropractor - 111N00000X

NPI Details
NPI 1003814336
Gender Male
Enumeration Date 07/11/2005
Last Updated 04/22/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
4014 77TH ST
STE. 2
KENOSHA WI, 53142-4314, US
Phone (262) 694-3530
Fax (262) 925-8810
Business Location
4014 77TH ST
STE. 2
KENOSHA WI, 53142-4314, US
Phone (262) 694-3530
Fax (262) 925-8810
Toxanomy
Taxonomy Code 111N00000X
License State Wisconsin
License Number 3514-012
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According to our database, Dr. Walter Rudolph Wiesztort D.C. NPI is 1003814336, taxonomy code is 111N00000X and license number is 3514-012, license state is located at Wisconsin. Walter Rudolph Wiesztort D.C. physically located at 4014 77th St, Kenosha WI, 53142-4314. NPI Number Walter Rudolph Wiesztort D.C. has the Individual type.

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1003814336 NPI number is provided on an as is basis without warranty of any kind. 1003814336 is maintained by the National Plan & Provider Enumeration System. The contents of Walter Rudolph Wiesztort D.C. are for informational purposes only.