Provider Demographics
NPI:1477522688
Name:WEISMANTEL, CRAIG WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:WILLIAM
Last Name:WEISMANTEL
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:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:OTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18942-0497
Mailing Address - Country:US
Mailing Address - Phone:215-536-4333
Mailing Address - Fax:215-536-5030
Practice Address - Street 1:312 JUNIPER ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1604
Practice Address - Country:US
Practice Address - Phone:215-536-4333
Practice Address - Fax:215-536-5030
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC8644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3325819OtherAETNA
PAAJ008574OtherADJUNCTIVE PROCEDURES
PA2010534000OtherPERSONAL CHOICE
PA664536OtherACN GROUP
PA2010534000OtherKEYSTONE AMERIHEALTH
PA001317223OtherHIGHMARK BCBS
PA2010534000OtherPERSONAL CHOICE
PA054433SKTMedicare ID - Type Unspecified