Individual
MRS. MIRANDA JO WIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
41 RICKEL RD, SUN PRAIRIE, WI 53590-1840
(608) 837-8529
Mailing address
N9193 STATE ROAD 78, BLANCHARDVILLE, WI 53516-9632
(608) 558-2382
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1435-019
WI
Other
Enumeration date
01/08/2009
Last updated
01/08/2009
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