Individual
KELSIE WIESELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
401 W DARLENE ST, HARTINGTON, NE 68739-4510
(402) 254-3905
Mailing address
56409 HIGHWAY 12, HARTINGTON, NE 68739-6069
(402) 841-6388
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1977
NE
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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