Individual
DR. GREGORY HAYLETT WEIDLICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
16869 65TH AVE # 356, LAKE OSWEGO, OR 97035-7865
(503) 336-1287
Mailing address
PO BOX 1368, LAKE OSWEGO, OR 97035-0536
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3432
OR
Other
Enumeration date
06/27/2011
Last updated
06/27/2011
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