Individual
MR. KEVIN WAYNE WIESNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 CHURCH RD, MARMORA, NJ 08223-1257
(609) 846-5786
Mailing address
22 CHURCH RD, MARMORA, NJ 08223-1257
(609) 846-5786
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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