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1679189146
MATTHEW THEODORE WIESKAMP
DAVENPORT, IA
NPI
1679189146
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2020-09-21
Last Update Date
2020-09-21
Business Address
MATTHEW THEODORE WIESKAMP
518 W LOCUST ST
DAVENPORT, IA 52803-2829
Phone number: 563-333-6000
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Mailing Address
MATTHEW THEODORE WIESKAMP
1678 TAYLOR AVE
MUSCATINE, IA 52761-9789
Phone number: 563-506-8373
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