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Individual

MRS. JAMIE MARIE WIESNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
308 MAIN ST, BRANDT, SD 57218-2010
(605) 876-3481
Mailing address
308 MAIN ST, BRANDT, SD 57218-2010
(605) 876-3481

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0588
SD
225X00000X
Occupational Therapist
103448
MN

Other

Enumeration date
05/12/2009
Last updated
05/12/2009
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