Individual
MICHELLE WEIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4614 S 132ND ST, OMAHA, NE 68137-1764
(402) 330-3211
Mailing address
9447B LORTON MARKET ST, #250, LORTON, VA 22079-1963
(703) 372-5716
(703) 372-5718
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305208560
VA
225100000X
Physical Therapist
3325
NM
225100000X
Physical Therapist
Primary
3683
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47065477701
—
NE
Enumeration date
04/07/2006
Last updated
08/10/2022
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