Individual
MR. THOMAS D WESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4 DEERWOOD AVE NW, WADENA, MN 56482-1296
(218) 631-1100
Mailing address
4 DEERWOOD AVE NW, WADENA, MN 56482-1296
(218) 631-1100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10417
MN
363AM0700X
Medical Physician Assistant
PAC0161
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18709
—
ND
Enumeration date
11/21/2006
Last updated
06/24/2008
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