Individual
MATTHEW WEISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5366 386TH ST NE, NORTH BRANCH, MN 55056-5833
(651) 674-8353
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 350-4606
(970) 350-4645
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/17/2018
Last updated
12/05/2019
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