Individual
DAWN WIETFELDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
4123 TAYLOR BLVD, LOUISVILLE, KY 40215-2341
(502) 363-7172
(502) 363-7174
Mailing address
60 STONECREST COURT, SUITE 140, SHELBYVILLE, KY 40065
(502) 647-4600
(502) 647-4607
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4867
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000349858
ANTHEM
KY
01
—
7045635
AETNA
KY
Enumeration date
11/21/2006
Last updated
09/16/2009
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