Weiderman, Brian Carlton

Weiderman, Brian Carlton is an individual health care provider with primary practice located at 3645 E. Overland Rd. , Meridian ID 83642. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Weiderman, Brian Carlton can be contacted via phone (208) 888-7765.

Contact Information

Primary practice address
3645 E. Overland Rd. Meridian ID 83642
Phone: (208) 888-7765
Fax: (208) 888-7955
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT2663 Idaho

Profile Details

NPI number 1831419332
LBN Legal business name Weiderman, Brian Carlton
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2010
Last updated Oct 8th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831419332 NPPES
Idaho Other 0330321 WA L&I
Idaho MEDICAID 1831419332 WA L&I
Idaho Other P00846336 WA L&I

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