Provider Demographics
NPI:1346724937
Name:WIELAND, CHRISTOPHER (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:WIELAND
Suffix:
Gender:M
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5725 CORPORATE WAY STE 209
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2035
Mailing Address - Country:US
Mailing Address - Phone:561-834-3330
Mailing Address - Fax:561-834-3445
Practice Address - Street 1:5725 CORPORATE WAY STE 209
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2035
Practice Address - Country:US
Practice Address - Phone:561-834-3330
Practice Address - Fax:561-834-3445
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty