Individual
CARRIE WIESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
214 LOCKE AVE SW, MASSILLON, OH 44646-3438
(330) 844-0133
Mailing address
214 LOCKE AVE SW, MASSILLON, OH 44646-3438
(330) 844-0133
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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