Provider Demographics
NPI:1154496719
Name:WEIPERT, KERRY LOUISE (RKT)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:LOUISE
Last Name:WEIPERT
Suffix:
Gender:F
Credentials:RKT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10952 MINX RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:MI
Mailing Address - Zip Code:48133-9744
Mailing Address - Country:US
Mailing Address - Phone:734-856-4870
Mailing Address - Fax:
Practice Address - Street 1:3130 CENTRAL PARK W
Practice Address - Street 2:SUITE A
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1094
Practice Address - Country:US
Practice Address - Phone:419-841-9622
Practice Address - Fax:419-843-8288
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1552226300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist