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Individual

MATTHEW W WEIRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5300 N ILLINOIS ST, STE 101, FAIRVIEW HEIGHTS, IL 62208-3500
(618) 624-9300
(618) 624-9330
Mailing address
5300 N ILLINOIS ST, STE 101, FAIRVIEW HEIGHTS, IL 62208-3500
(618) 624-9300
(618) 624-9330

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.009711
IL
225X00000X
Occupational Therapist
2012003356
MO

Other

Enumeration date
03/07/2012
Last updated
12/19/2015
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