Individual
THOMAS E WEIBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1265 W HURON ST STE 101, WATERFORD, MI 48328-3677
(248) 977-4594
Mailing address
52 ADAMS LAKE DR APT 6, WATERFORD, MI 48328-2927
(248) 202-1537
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501003179
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7501003179
ABMP
MI
Enumeration date
08/17/2018
Last updated
08/17/2018
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