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NPI 1699690891

NPI 1699690891 : DYLAN JAMES WIEST CPO : GREENFIELD, WI

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General NPI Number Information
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    NPI Number           |    1699690891
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    Entity Type          |    Individual 
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    Provider Name        |    DYLAN JAMES WIEST CPO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/13/2026
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    Last Update Date     |    08/14/2026
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Provider Practice Location Address
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    Address Line         |    6790 W LAYTON AVE 
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    City                 |    GREENFIELD
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    State                |    WI
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    Zip                  |    53220-4571
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    Country              |    US
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    Telephone            |    414-282-3100
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    Fax                  |    414-282-3101
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Provider Business Mailing Address
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    Address Line         |    6790 W LAYTON AVE 
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    City                 |    GREENFIELD
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    State                |    WI
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    Zip                  |    53220-4571
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    Country              |    US
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    Telephone            |    414-259-1950
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    224P00000X
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    Taxonomy Name        |    Prosthetist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    222Z00000X
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    Taxonomy Name        |    Orthotist
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    License Number       |    
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    License Number State |    
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