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Individual

JASON DONALD WIETECKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
3306 MEIJER DR, TOLEDO, OH 43617-3103
(419) 824-3434
Mailing address
4230 LANCELOT RD, TOLEDO, OH 43623-2520

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25398
MA
225100000X
Physical Therapist
PT018928
OH

Other

Enumeration date
09/09/2020
Last updated
02/10/2021
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