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Dr. Walter Rudolph Wiesztort, DC
Chiropractor in Kenosha, Wisconsin
NPI 1003814336

Walter Rudolph Wiesztort is a Chiropractor based in Kenosha, WI. Walter Rudolph Wiesztort practices in Kenosha, WI and has the professional credentials of DC. The NPI Number for Walter Rudolph Wiesztort is 1003814336 and holds a License No. 3514-012 (Wisconsin).

The current practice location address for Walter Rudolph Wiesztort is 4014 77Th St, Kenosha, WI and can be reached out via phone at 262-694-3530 and via fax at 262-925-8810. You can also correspond with Walter Rudolph Wiesztort through the mailing address at 4014 77TH ST, KENOSHA, WI - 53142-4314 (mailing address contact number: 262-694-3530).

Location: 4014 77Th St, Kenosha, WI, 53142-4314
person
Provider Profile Details
NPI Number
1003814336
Provider Name
Walter Rudolph Wiesztort
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
4014 77Th St, Kenosha, WI, 53142-4314
Phone Number
262-694-3530
Fax Number
262-925-8810
Provider Enumeration Date
07/11/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
38911900 05 WI
521540114 01 MACS
4400259 01 UHC
0005896742 01 AETNA
0191565 01 CIGNA
721524922010 01 WI BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
4014 77Th St
City
State
Zip
53142-4314
Phone Number
262-694-3530
Fax Number
262-925-8810
person
Provider Business Mailing Address Details
Address
4014 77Th St
City
State
Zip
53142-4314
Phone Number
262-694-3530
Fax Number
262-925-8810
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
License No.
3514-012 (Wisconsin)
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.
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