Provider Demographics
NPI:1326808346
Name:WEISSMAN, BRYAN B (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:B
Last Name:WEISSMAN
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 1:5825 NW 42ND TER
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2748
Mailing Address - Country:US
Mailing Address - Phone:954-994-4411
Mailing Address - Fax:
Practice Address - Street 1:5825 NW 42ND TER
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2748
Practice Address - Country:US
Practice Address - Phone:954-994-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX4195111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor