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Organization

PERSONAL CARE MEDICAL ENTERPRISE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. NICOLAS WIEGAND (PRESIDENT/OWNER)
(636) 477-6085
Entity
Organization

Contact information

Practice address
5933 S HIGHWAY 94, SUITE 102, WELDON SPRING, MO 63304-5610
(636) 477-6085
Mailing address
5933 S HIGHWAY 94, SUITE 102, WELDON SPRING, MO 63304-5610
(636) 477-6085

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
LC1363451
MO

Other

Enumeration date
08/12/2014
Last updated
08/12/2014
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