Provider Demographics
NPI:1083047542
Name:WEIK, DAVID A (DPT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:WEIK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1169 HILLTOP PKWY
Mailing Address - Street 2:UNIT 202B
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-2523
Mailing Address - Country:US
Mailing Address - Phone:970-879-7799
Mailing Address - Fax:970-879-1262
Practice Address - Street 1:1169 HILLTOP PKWY
Practice Address - Street 2:UNIT 202B
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-2523
Practice Address - Country:US
Practice Address - Phone:970-879-7799
Practice Address - Fax:970-879-1262
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO066607Medicare UPIN