Individual
CHARLES WIESNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7101
(501) 686-7000
Mailing address
3104 PINTO RD, WHITE HALL, AR 71602-2560
(828) 429-6489
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1385
AR
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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