Individual
DR. JAMIE T WIEKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT 36269
Contact information
Practice address
141 W WILSHIRE AVE, STE C, FULLERTON, CA 92832-1858
(530) 518-8673
Mailing address
141 W WILSHIRE AVE, STE C, FULLERTON, CA 92832-1858
(530) 518-8673
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT 36269
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT36269
PHYSICAL THERAPY LICENSE
CA
Enumeration date
12/21/2009
Last updated
11/12/2014
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