| Dawn Wietfeldt, DC | |
|
4123 Taylor Blvd, Louisville, KY 40215-2341 | |
| (502) 363-7172 | |
| (502) 363-7174 |
| Full Name | Dawn Wietfeldt |
|---|---|
| Gender | Female |
| Speciality | Chiropractor |
| Location | 4123 Taylor Blvd, Louisville, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235204744 | NPI | - | NPPES |
| 7045635 | Other | KY | AETNA |
| 000000349858 | Other | KY | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 4867 (Kentucky) | Primary |
| Provider Name | Lynn Gail Pllc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1457554503 PECOS PAC ID: 7214073899 Enrollment ID: O20091013000259 |
| Mailing Address | Practice Location Address |
|---|---|
| Dawn Wietfeldt, DC 60 Stonecrest Court, Suite 140, Shelbyville, KY 40065 Ph: (502) 647-4600 | Dawn Wietfeldt, DC 4123 Taylor Blvd, Louisville, KY 40215-2341 Ph: (502) 363-7172 |
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