| Gregory N Wiersema, MST-CCC/A | |
|
221 Fond Du Lac Ave, Fond Du Lac, WI 54935-5303 | |
| (920) 923-4678 | |
| (920) 923-4678 |
| Full Name | Gregory N Wiersema |
|---|---|
| Gender | Male |
| Speciality | Audiologist-hearing Aid Fitter |
| Location | 221 Fond Du Lac Ave, Fond Du Lac, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831195361 | NPI | - | NPPES |
| 41105900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | 55-156 (Wisconsin) | Primary |
| 237600000X | Audiologist-hearing Aid Fitter | 55-156 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory N Wiersema, MST-CCC/A 221 Fond Du Lac Ave, Fond Du Lac, WI 54935-5303 Ph: (920) 923-4678 | Gregory N Wiersema, MST-CCC/A 221 Fond Du Lac Ave, Fond Du Lac, WI 54935-5303 Ph: (920) 923-4678 |
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