Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | F1-0000797 | DE |
NPI | 1013203991 |
---|---|
Provider Name | Matthew Paul Weik |
First Address | Wilmington, DE 19802-3900 |
Second Address | Wilmington, DE 19806-4006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2011 |
Last Update Date | 08/06/2018 |