Individual
MIKE WIECZOREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1801 VIRGINIA DR, GRAND ISLAND, NE 68803-5030
(308) 390-8386
Mailing address
1801 VIRGINIA DR, GRAND ISLAND, NE 68803-5030
(308) 390-8386
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
02/07/2025
Last updated
02/07/2025
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