Provider Demographics
NPI:1003091158
Name:WIELAND, THOMAS ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANTHONY
Last Name:WIELAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 BETHEL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-1864
Mailing Address - Country:US
Mailing Address - Phone:614-326-3374
Mailing Address - Fax:614-326-3378
Practice Address - Street 1:1908 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-1864
Practice Address - Country:US
Practice Address - Phone:614-326-3374
Practice Address - Fax:614-326-3378
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1169111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor