Individual
MS. MARY KATHRYN WIEDENHOEFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OM LAC NCCDOM
Contact information
Practice address
17130 ROYAL PALM BLVD, SUITE 2, WESTON, FL 33326
(954) 389-8404
(954) 389-8404
Mailing address
12717 NW 11TH COURT, SUNRISE, FL 33323
(954) 328-2964
(954) 389-8404
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP1975
FL
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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