Individual
RYAN MATTHEW WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(260) 373-4000
(260) 482-4442
Mailing address
3640 NEW VISION DR, SUITE A, FORT WAYNE, IN 46845-1716
(260) 482-4440
(260) 482-4442
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
99054150A
IN
Other
Enumeration date
10/03/2012
Last updated
05/16/2013
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