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General NPI Number Information
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NPI Number | 1871968032
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Entity Type | Organization
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Legal Business Name | WIEDNER FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 12/14/2015
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Last Update Date | 12/14/2015
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Provider Practice Location Address
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Address Line | 931 SE OCEAN BLVD STE C
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City | STUART
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State | FL
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Zip | 34994-2425
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Country | US
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Telephone | 772-781-1101
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Fax | 772-781-1141
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Provider Business Mailing Address
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Address Line | 931 SE OCEAN BLVD STE C
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City | STUART
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State | FL
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Zip | 34994-2425
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Country | US
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Telephone | 772-781-1101
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Fax | 772-781-1141
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Authorized Official
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Title or Position | INSURANCE
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Name | MS. OLGA VEIGA
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Credential |
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Telephone | 772-781-1101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | CH7269
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | CH7269
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License Number State | FL
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