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Individual

MRS. MAGDALENA WEIMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
701 E ALICE ST, BLACKFOOT, ID 83221-4925
(208) 782-2625
(208) 785-1003
Mailing address
701 E ALICE ST, BLACKFOOT, ID 83221-4925
(208) 782-2625
(208) 782-2625

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
222Q00000X
ID

Other

Enumeration date
03/01/2016
Last updated
03/01/2016
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