Individual
AMY ELIZABETH WEISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4330 SOUTHPORT SUPPLY RD SE STE 201, SOUTHPORT, NC 28461-9273
(901) 457-0113
Mailing address
109 PIER MASTER PT UNIT 201, WILMINGTON, NC 28412-5602
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
3637
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7211899
—
NC
Enumeration date
09/05/2019
Last updated
09/05/2019
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