Individual
GORDON DAVID WEIDEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
818 COLORADO AVE, SUITE 300, GLENWOOD SPRINGS, CO 81601
(970) 379-5197
(970) 945-0409
Mailing address
P.O. BOX 3053, GLENWOOD SPRINGS, CO 81602
(970) 379-5197
(970) 947-9048
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5081
CO
2251X0800X
Orthopedic Physical Therapist
Primary
5081
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5081
STATE LICENSE NUMBER
CO
Enumeration date
06/28/2010
Last updated
11/29/2023
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