Provider Demographics
NPI:1013027564
Name:WEISS, KEITH ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ANDREW
Last Name:WEISS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5611
Mailing Address - Country:US
Mailing Address - Phone:603-224-1846
Mailing Address - Fax:
Practice Address - Street 1:133 LOUDON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5611
Practice Address - Country:US
Practice Address - Phone:603-224-1846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH550-1198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0502688Y0NH01OtherANTHEM BLUE CROSS BLUE SH
NH1617316OtherCIGNA
NHU84414OtherHARVARD PILGRIM HC
NH1617316OtherCIGNA