Provider Demographics
NPI:1376532523
Name:WEYAND, JOHN SPENCER (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SPENCER
Last Name:WEYAND
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 1:20 PARK DR
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-2213
Mailing Address - Country:US
Mailing Address - Phone:607-324-7246
Mailing Address - Fax:607-324-7249
Practice Address - Street 1:20 PARK DR
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-2213
Practice Address - Country:US
Practice Address - Phone:607-324-7246
Practice Address - Fax:607-324-7249
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006902-1111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56806BMedicare ID - Type Unspecified
NYU27403Medicare UPIN