Individual
DOUGLAS K WIESNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
10777 NALL AVE, SUITE 320, OVERLAND PARK, KS 66211-1362
(913) 663-2555
(913) 312-1781
Mailing address
10701 NALL AVE, SUITE 130, OVERLAND PARK, KS 66211-1363
(913) 663-2555
(913) 663-3766
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00151
KS
Other
Enumeration date
06/04/2006
Last updated
10/04/2010
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