John Ryder Wiese

NPI #1912861790 in Blanchard, Oklahoma

Provider Information

NPI Number: 1912861790
Entity Type: Individual
Name: John Ryder Wiese
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Dec 15, 2025
Last Updated: Dec 15, 2025

Practice Location

Address: 3011 MALLARD CIR
City: Blanchard
State: Oklahoma
ZIP Code: 73010-8935
Phone: (405) 761-3902

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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