Individual
MR. SCOTT MARTIN VANDER WIELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
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
111N00000X
Chiropractor
Primary
4565-012
WI
Other
Enumeration date
08/12/2009
Last updated
06/15/2022
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