Doctor Name: | DR. BRANDON O'NEILL WIELERT |
NPI Number: | 1629418124 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.T. |
License Number: | 2013019356 |
Business Practice Address: | 1206 N Main St Mountain Grove, MO - 65711 |
Business Phone Number: | 4179265699 |
Business Fax Number: | |
Mailing Address: | 1444 Grandview Dr, WARRENSBURG |
State: | MO |
Postal Code: | 640939531 |
Phone Number: | 6609092494 |
Fax Number: | |
NPI Enumeration Date: | 06/28/2013 |
NPI Last Update Date: | 06/28/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2013019356 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |