Individual
JENNA WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
680 PILLSBURY ST N, PILLAGER, MN 56473-2507
(218) 746-4527
Mailing address
680 PILLSBURY ST N, PILLAGER, MN 56473-2507
(218) 746-4527
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13798
MN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
05/17/2021
Last updated
03/10/2022
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