Organization
WEBER PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIERSTEN B WEBER DPM (OWNER)
(405) 819-1182
Entity
Organization
Contact information
Practice address
1501 AUTUMN CREEK DR, EDMOND, OK 73003-3500
(405) 819-1182
(405) 285-8921
Mailing address
PO BOX 8373, EDMOND, OK 73083-8373
14058191182
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
212
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200180850A
—
OK
Enumeration date
09/19/2017
Last updated
09/19/2017
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