Provider Demographics
NPI:1699144246
Name:WIECHMANN, NATHANIEL (BS, DC)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:
Last Name:WIECHMANN
Suffix:
Gender:M
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:OAKLAND
Mailing Address - State:IA
Mailing Address - Zip Code:51560-4356
Mailing Address - Country:US
Mailing Address - Phone:712-249-8231
Mailing Address - Fax:
Practice Address - Street 1:101 N MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:OAKLAND
Practice Address - State:IA
Practice Address - Zip Code:51560-4356
Practice Address - Country:US
Practice Address - Phone:712-249-8231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-24
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA082353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor