Individual
BARRY WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Mailing address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2014005327
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2014005327
MO LICENSE
MO
Enumeration date
05/04/2006
Last updated
03/06/2015
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