Organization
SOUTH SIDE FOOT AND ANKLE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIE A WIEGER DPM (OWNER)
(574) 231-1960
Entity
Organization
Contact information
Practice address
3506 S MICHIGAN ST, SOUTH BEND, IN 46614-1728
(574) 231-1960
(574) 231-1961
Mailing address
3506 S MICHIGAN ST, SOUTH BEND, IN 46614-1728
(574) 231-1960
(574) 231-1961
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07000810A
IN
Other
Enumeration date
01/27/2010
Last updated
01/27/2010
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