MR. KIM WIESE, PA-C
Physician Assistant
Active
Individual
NPI: 1801866744
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant | 363A00000X | Yes | 085.006503 (IL) |
Frequently Asked Questions
NPI 1801866744 is the National Provider Identifier for MR. KIM WIESE, PA-C, a Physician Assistant provider located in Peoria, IL. This NPI was enumerated on January 24, 2006.
MR. KIM WIESE, PA-C practices at 1524 W GLEN AVE, Peoria, IL 61614.
Quick Facts
- NPI
- 1801866744
- Type
- Individual
- Enumerated
- Jan 24, 2006
- Last Updated
- May 19, 2020
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