# THERESA WEILAND DO PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366616716
- **Authorized official:** STEVEN CSIK (CORP SECRETARY)
- **Authorized official phone:** (208) 333-8841

## Contact information

- **Practice address:** 222 N 2ND ST, SUITE 201, BOISE, ID 83702-6109
- **Practice address phone:** (208) 345-7727
- **Practice address fax:** (208) 345-4689
- **Mailing address:** 2245 TOLUKA WAY, BOISE, ID 83712-8552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | O-119 | ID | Yes |

## Other

- **Enumeration date:** 04/16/2008
- **Last updated:** 04/16/2008