Dr. Walter Rudolph Wiesztort
Chiropractor
4014 77th St Ste. 2
Kenosha
, Wisconsin 53142-4314
Dr. Walter Rudolph Wiesztort
Chiropractor
4014 77th St Ste. 2
Kenosha
, Wisconsin 53142-4314
(262) 925-8810
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About
Features
Specialties
- Chiropractor
Languages spoken
- English
Location
First Address
- Dr. Walter Rudolph Wiesztort
- 4014 77th St Ste. 2
- Kenosha, WI
- Zip : 53142-4314
- Fax : (262) 925-8810
- Phone : (262) 694-3530
Second Address
- Dr. Walter Rudolph Wiesztort
- 4014 77th St Ste. 2
- Kenosha, WI
- Zip : 53142-4314
- Fax : (262) 925-8810
- Phone : (262) 694-3530
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 3514-012 | WI |
National Provider Identifier
| NPI | 1003814336 |
|---|---|
| Provider Name | Dr. Walter Rudolph Wiesztort |
| First Address | Kenosha, WI 53142-4314 |
| Second Address | Kenosha, WI 53142-4314 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/07/2005 |
| Last Update Date | 22/04/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0005896742 | AETNA (01) | |
| 0191565 | CIGNA (01) | |
| 38911900 | (05) | WI |
| 4400259 | UHC (01) | |
| 521540114 | MACS (01) | |
| 721524922010 | BLUE CROSS BLUE SHIELD (01) | WI |
| U75790 | (02) | WI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.