Individual
SARAH J WIESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
502 N 9TH AVE, VINTON, IA 52349-2254
(319) 472-6372
Mailing address
2050 GLEN OAKS RDG, CORALVILLE, IA 52241-3482
(319) 341-7162
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01017
IA
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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