Individual
DR. JASON ANDREW WIESE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
15478 RUGGLES ST., SUITE 110, OMAHA, NE 68116
(402) 934-4220
Mailing address
15478 RUGGLES ST., SUITE 110, OMAHA, NE 68116
(402) 934-4220
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1400
NE
Other
Enumeration date
03/10/2006
Last updated
07/08/2007
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