Individual
LANDON WIEDENMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.T.
Contact information
Practice address
220 E. BROADWAY, JACKSON, WY 83001
(307) 413-8949
(307) 459-4982
Mailing address
PO BOX 6396, JACKSON, WY 83002-6396
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
01/10/2011
Last updated
01/10/2011
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