Organization
VANDER WIELEN HEALTH & WELLNESS DIAGNOSTIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT MARTIN VANDER WIELEN D.C. (REGISTERED AGENT)
(920) 722-2100
Entity
Organization
Contact information
Practice address
1486 KENWOOD DR, MENASHA, WI 54952-1133
(920) 722-2100
(920) 722-2100
Mailing address
1486 KENWOOD DR, MENASHA, WI 54952-1133
(920) 722-2100
(920) 722-2101
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
—
—
Other
Enumeration date
12/21/2009
Last updated
06/16/2022
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