Individual
DR. JEFFREY EDWARD WIEDERHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
7117 S WESTNEDGE AVE, SUITE #3, PORTAGE, MI 49002-4201
(269) 327-4813
Mailing address
7117 S WESTNEDGE AVE, SUITE #3, PORTAGE, MI 49002-4201
(269) 327-4813
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009586
MI
Other
Enumeration date
08/17/2009
Last updated
07/01/2010
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