Individual
MR. JON M WIESELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1001 SOUTH COTTONWOOD, NORTH PLATTE, NE 69101-6138
(308) 532-5480
(308) 532-5480
Mailing address
1001 SOUTH COTTONWOOD, NORTH PLATTE, NE 69101-6138
(308) 532-5480
(308) 532-5480
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
546
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10024973400
—
NE
01
—
39616
BCBS
NE
01
—
CK7267
RR MEDICARE
NE
Enumeration date
12/26/2006
Last updated
07/08/2007
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