Individual
MALLORY WIELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
507 S MONROE ST, LANCASTER, WI 53813-2054
(608) 723-2143
Mailing address
507 S MONROE ST, LANCASTER, WI 53813-2054
(608) 723-2143
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3065-19
WI
Other
Enumeration date
01/21/2021
Last updated
07/18/2023
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