Individual
MS. ANN DEPAOLO WIETSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
45 N MAIN ST, KILMARNOCK, VA 22482-8501
(804) 435-0758
(804) 435-7226
Mailing address
PO BOX 1911, 45 N MAIN STREET, KILMARNOCK, VA 22482-1911
(804) 435-0758
(804) 435-7226
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201001146
VA
Other
Enumeration date
03/16/2006
Last updated
04/14/2008
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