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Individual

HOLLY J WEILAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
210 WISCONSIN AMERICAN DR, FOND DU LAC, WI 54937-2999
(920) 907-7270
Mailing address
210 WISCONSIN AMERICAN DR, FOND DU LAC, WI 54937-2999

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
13512-24
WI
225100000X
Physical Therapist
Primary
13512
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10070734
WI
Enumeration date
08/02/2017
Last updated
12/19/2019
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