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Individual

MATHEW LEE WIBEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ABC C.PED

Contact information

Practice address
3 SAINT CHARLES PL, LITTLE CHUTE, WI 54140-2256
(715) 307-9071
Mailing address
3 SAINT CHARLES PL, LITTLE CHUTE, WI 54140-2256
(715) 307-9071

Taxonomy

Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
WI
224L00000X
Pedorthist

Other

Enumeration date
12/05/2018
Last updated
12/05/2018
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