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Individual
DR. WALTER RUDOLPH WIESZTORT
Active
Individual
DR. WALTER RUDOLPH WIESZTORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3514-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005896742
AETNA
—
01
—
0191565
CIGNA
—
05
—
38911900
—
WI
01
—
4400259
UHC
—
01
—
521540114
MACS
—
01
—
721524922010
BLUE CROSS BLUE SHIELD
WI
Enumeration date
07/11/2005
Last updated
04/22/2008
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