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Individual

TERRY J WEIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
12266 DEPAUL DR, 110, BRIDGETON, MO 63044-2514
(314) 291-7900
(314) 291-7914
Mailing address
16582 BAXTER FOREST RIDGE DR, CHESTERFIELD, MO 63005-4662
(314) 291-7900

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
R5197
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
240975904
MO
Enumeration date
07/14/2006
Last updated
03/03/2011
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