Individual
CHRISTIAN DOUGLAS WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4730 E LONE MOUNTAIN RD STE 114, CAVE CREEK, AZ 85331-5539
(480) 272-7140
Mailing address
4409 E MEADOW DR, PHOENIX, AZ 85032-9324
(602) 818-7845
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
014476
AZ
Other
Enumeration date
05/05/2022
Last updated
05/05/2022
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