Individual
KATIE WEIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RT(R)(CT)
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-3411
Mailing address
2586 GEMINI RD, GREEN BAY, WI 54311-4608
(920) 217-6212
Taxonomy
Speciality
Code
Description
License number
State
2471C3401X
Computed Tomography Radiologic Technologist
Primary
427695
WI
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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