Individual
DR. GLENN ALAN WIELENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
807 S. 5TH AVE, PLAINS, MT 59859
(406) 826-3141
(406) 826-5505
Mailing address
PO BOX 1119, PLAINS, MT 59859-1119
(406) 826-3141
(406) 826-5505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4937
MT
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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