Individual
MATTHEW T WIEDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1 3RD AVE NE, CROSBY, MN 56441-1665
(218) 546-5108
(218) 546-5736
Mailing address
1 3RD AVE NE, CROSBY, MN 56441-1665
(218) 546-5108
(218) 546-5736
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4018
MN
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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