Individual
CASEY WIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LMT
Contact information
Practice address
2368 EASTCLEFT DR, UPPER ARLINGTON, OH 43221-1852
(614) 906-7766
Mailing address
2368 EASTCLEFT DR, UPPER ARLINGTON, OH 43221-1852
(614) 906-7766
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.003604
OH
225700000X
Massage Therapist
33.014715-T-Z
OH
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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