LUTHER ROSWELL WIEST

FORT DRUM, NY
NPI1053402560
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: VA  0102201634)
Enumeration Date2006-09-28
Last Update Date2011-07-01
Business Address
Dr. LUTHER ROSWELL WIEST D.O.
11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602-5438
Phone number: 315-772-3679
Mailing Address
Dr. LUTHER ROSWELL WIEST D.O.
11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602-5438
Phone number: