Individual
CHARLES WIELAND III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 WEST EDGAR, CASEY, IL 62420-1099
(217) 932-4004
Mailing address
202 WEST EDGAR, CASEY, IL 62420-1099
(217) 932-4004
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.297718
IL
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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