Individual
DR. REBECCA WEIDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
10625 W NORTH AVE STE LL3, WAUWATOSA, WI 53226-2315
(414) 852-1330
Mailing address
10625 W NORTH AVE STE LL3, WAUWATOSA, WI 53226-2315
(414) 852-1330
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5026-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215335047
—
WI
Enumeration date
12/10/2014
Last updated
01/10/2019
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