Individual
MR. BRIAN WILLIAM WIESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT
Contact information
Practice address
116 WARD SPORTS MEDICINE BUILDING, GREENVILLE, NC 27858-4353
(252) 737-4749
(252) 737-1275
Mailing address
116 WARD SPORTS MEDICINE BUILDING, GREENVILLE, NC 27858-4353
(252) 737-4749
(252) 737-1275
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2391
NC
Other
Enumeration date
01/17/2014
Last updated
01/17/2014
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