Individual
MICHAEL WIELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
612 35TH AVE, MOLINE, IL 61265-6176
(309) 788-0014
(309) 623-4638
Mailing address
612 35TH AVE, MOLINE, IL 61265-6176
(309) 788-0014
(309) 623-4638
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/06/2020
Last updated
06/15/2022
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