Individual
MATTHEW THEODORE WIESKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
518 W LOCUST ST, DAVENPORT, IA 52803-2829
(563) 333-6000
Mailing address
1678 TAYLOR AVE, MUSCATINE, IA 52761-9789
(563) 506-8373
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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