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Individual

DR. JEROME J WIEDEMEIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
116 NORTH MAIN ST., BUFFALO CENTER, IA 50424
(641) 562-2020
(641) 562-2924
Mailing address
116 NORTH MAIN ST., P.O. BOX 323, BUFFALO CENTER, IA 50424
(641) 562-2020
(641) 562-2924

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A5749
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0120493
IA
01
14184
BLUE CROSS & BLUE SHIELD
IA
01
3C972BU
BC/BS OF MN
Enumeration date
06/14/2006
Last updated
01/26/2010
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