Individual
JAMIE WEISHAAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
745 S PROGRESS AVE, MERIDIAN, ID 83642-5619
(208) 895-0309
(208) 895-0311
Mailing address
745 S PROGRESS AVE, MERIDIAN, ID 83642-5619
(208) 895-0309
(208) 895-0311
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT28099
CA
225100000X
Physical Therapist
Primary
PT2909
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT10765
PHYSICAL THERAPY
CO
01
—
PT28099
PHYSICAL THERAPY
CA
01
—
PT2909
PHYSICAL THERAPY
ID
Enumeration date
02/06/2007
Last updated
10/16/2015
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