Wiesenfarth Simone, Mary Ellen

Wiesenfarth Simone, Mary Ellen is an sole proprietor health care provider with primary practice located at 275 W San Bernardino Rd , Covina CA 91723-1516. She recently has 3 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Chiropractic Providers / Occupational Health, Chiropractic Providers / Independent Medical Examiner. Chiropractic Providers / Independent Medical Examiner is her primary health care specialty. Wiesenfarth Simone, Mary Ellen can be contacted via phone (626) 967-3553.

Contact Information

Primary practice address
275 W San Bernardino Rd Covina CA 91723-1516
Phone: (626) 967-3553
Fax: (626) 967-1523
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X DC22891 California
Chiropractic Providers / Occupational Health 111NX0100X DC22891 California
Chiropractic Providers / Independent Medical Examiner 111NI0013X DC22891 California

Profile Details

NPI number 1144597006
LBN Legal business name Wiesenfarth Simone, Mary Ellen
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 21st, 2011
Last updated Nov 21st, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144597006 NPPES
California Other DC22891 LICENSE

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