Individual
KRISTA JEAN WIENEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14440 28TH PL N STE 200, PLYMOUTH, MN 55447-4854
(612) 707-0169
(612) 465-1603
Mailing address
2031 FAIRMOUNT AVE, SAINT PAUL, MN 55105-1548
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6686
MN
Other
Enumeration date
04/10/2007
Last updated
01/09/2024
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