Individual provider · Type 1 NPI
Gary Mark Wiedeman, DC
Chiropractor · Greeley, CO
NPI number
1205855509
Active
Practice location
2716 23rd Ave
Greeley, CO 80634-6920
Fax (970) 353-5332
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 1689 (CO) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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About NPI 1205855509
Gary Mark Wiedeman, DC's National Provider Identifier is 1205855509, issued on Jul 18, 2006. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Greeley, CO. The record was last updated on Jul 9, 2012.