Individual
MATTHEW SCOTT WEIGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
520 N CANYON ST, SPEARFISH, SD 57783-2320
(605) 642-7996
(605) 642-5955
Mailing address
520 N CANYON ST, SPEARFISH, SD 57783-2320
(605) 642-7996
(605) 642-5955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1629
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104025907
WELLMARK BC/BS
SD
05
—
1104025907
—
SD
Enumeration date
07/12/2007
Last updated
11/08/2012
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