IndividualActive
Kimberly Wiegand, CFM
NPI 1720230873 · Orthotic Fitter · Maryville, IL
Provider details
- NPI number
- 1720230873
- Entity type
- Individual
- Primary specialty
- Orthotic FitterRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CFM
- Sex
- Female
- Sole proprietor
- No
- License
- 049-177617 (IL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Pharmacy Service Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2700 N Center St
Rte 159
Maryville, IL 62062-5624
Phone: (618) 288-7474
Fax: (618) 288-7037
Approximate (ZIP-level) locationGet directions
Mailing address
2700 N Center St
Maryville, IL 62062-5624
Registry dates
- Enumerated
- 2008-10-21
- Last updated
- 2008-10-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.