Individual
TRAVIS J WEISZHAAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
37 S 2ND E, REXBURG, ID 83440-1906
(208) 356-0234
(208) 356-9141
Mailing address
37 S 2ND E, REXBURG, ID 83440-1906
(208) 356-0234
(208) 356-9141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA264
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8041599100
—
ID
Enumeration date
10/23/2006
Last updated
06/29/2021
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