Individual
DR. AMY SUSANNE HIETALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
215 N 2ND ST, 201, RIVER FALLS, WI 54022-3706
(715) 425-6665
(715) 425-6677
Mailing address
1419 FRANKLIN ST, BALDWIN, WI 54002-9319
(920) 889-0007
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3470
WI
111N00000X
Chiropractor
MN3382
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38925900
—
WI
Enumeration date
10/20/2006
Last updated
01/06/2015
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