Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 038007329 | IL |
NPI | 1326096553 |
---|---|
Provider Name | Curt A Wesselmann |
First Address | Trenton, IL 62293-1110 |
Second Address | Trenton, IL 62293-1110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 28/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
038007329 | (05) | IL |
K32183 | (02) | IL |