Individual
MR. MICHAEL TODD WIETMARSCHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
323 E TOWN ST, COLUMBUS, OH 43215-4767
(614) 461-8714
(614) 461-9155
Mailing address
5400 FRANTZ RD, STE 250, DUBLIN, OH 43016-4144
(614) 544-6382
(614) 544-6370
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT002804
OH
363AS0400X
Surgical Physician Assistant
Primary
50.003003
OH
Other
Enumeration date
10/23/2006
Last updated
01/25/2022
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