Doctor Name: | DAWN WIETFELDT |
NPI Number: | 1235204744 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DC |
License Number: | 4867 |
Business Practice Address: | 4123 Taylor Blvd Louisville, KY - 402152341 |
Business Phone Number: | 5023637172 |
Business Fax Number: | 5023637174 |
Mailing Address: | 60 Stonecrest Court, Suite 140 SHELBYVILLE |
State: | KY |
Postal Code: | 40065 |
Phone Number: | 5026474600 |
Fax Number: | 5026474607 |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 09/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 4867 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |