Provider Demographics
NPI:1477072726
Name:WEICHERS, KIMBERLY (DPT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:WEICHERS
Suffix:
Gender:F
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:PO BOX 4357
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-4357
Mailing Address - Country:US
Mailing Address - Phone:406-862-9378
Mailing Address - Fax:406-862-9882
Practice Address - Street 1:2006 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-7858
Practice Address - Country:US
Practice Address - Phone:406-862-9378
Practice Address - Fax:406-862-9882
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist