Individual
DR. THERESA ANN WEILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
500 W FORT ST, # 111 PC, BOISE, ID 83702
(208) 422-1000
(208) 422-1319
Mailing address
2245 TOLUKA WAY, BOISE, ID 83712-8552
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O119
ID
Other
Enumeration date
02/23/2007
Last updated
03/16/2022
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