Individual
HARRY JAKE WIENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5432 E SOUTHERN AVE, STE. 101, MESA, AZ 85206-2772
(480) 325-3275
(480) 981-9123
Mailing address
5432 E SOUTHERN AVE, STE. 101, MESA, AZ 85206-2772
(480) 325-3275
(480) 981-9123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13419
AZ
Other
Enumeration date
04/25/2006
Last updated
08/23/2011
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