Individual
JOANNA WENAS WIDJAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
204 1ST ST STE 111, SERGEANT BLUFF, IA 51054-8532
(712) 301-7537
Mailing address
204 1ST ST STE 111, SERGEANT BLUFF, IA 51054-8532
(712) 823-3127
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
125921
IA
Other
Enumeration date
08/05/2024
Last updated
09/20/2024
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