MEDICARE: DR. THOMAS ANTHONY WIELAND DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1169	OH

General Provider Information

NPI Number	:	1003091158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS ANTHONY WIELAND DC

Provider Business Mailing Address
First Line	:	1908 BETHEL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-1864
Country	:	US
Telephone Number	:	614-326-3374
Fax Number	:	614-326-3378

Provider Business Practice Location Address
First Line	:	1908 BETHEL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-1864
Country	:	US
Telephone Number	:	614-326-3374
Fax Number	:	614-326-3378

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	01/08/2008

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