DR. Joshua Daniel Wideman, DC

NPI #1578078838 in Granite City, Illinois

Provider Information

NPI Number: 1578078838
Entity Type: Individual
Name: DR. Joshua Daniel Wideman, DC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Chiropractor
Credential: DC
Enumeration Date: Dec 8, 2017
Last Updated: Feb 4, 2020

Practice Location

Address: 3986 MARYVILLE RD
City: Granite City
State: Illinois
ZIP Code: 62040-4191
Phone: (618) 797-0618

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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