Individual
CHRISTIAN ROSS WEIDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3250 WINKLER AVE FL 33916, FORT MYERS, FL 33916-9414
(239) 939-4993
Mailing address
5337 LAKEWOOD DR, MILTON, FL 32570-6827
(302) 344-7706
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
30350
FL
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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