Provider Demographics
NPI:1144255423
Name:WEBER, GENEVIEVE E (DC)
Entity type:Individual
Prefix:DR
First Name:GENEVIEVE
Middle Name:E
Last Name:WEBER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:ND
Mailing Address - Zip Code:58341
Mailing Address - Country:US
Mailing Address - Phone:701-324-2335
Mailing Address - Fax:
Practice Address - Street 1:1008 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:ND
Practice Address - Zip Code:58341
Practice Address - Country:US
Practice Address - Phone:701-324-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND4293OtherBLUE CROSS
ND12957Medicaid
ND000481OtherEDI
NDN1000365Other'MEDICARE ID-PIN'
T66832Medicare UPIN