Individual
DR. WYATT ISAAC WIEDENFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
853 S MAIN ST, OCONTO FALLS, WI 54154-1203
(920) 496-4700
Mailing address
853 S MAIN ST, STE A, OCONTO FALLS, WI 54154-1212
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901002524
MI
Other
Enumeration date
06/05/2014
Last updated
04/23/2019
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