Provider Demographics
NPI:1598728610
Name:WEISS, PAUL C (PT)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:C
Last Name:WEISS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5409 WHITE BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9336
Mailing Address - Country:US
Mailing Address - Phone:336-644-9661
Mailing Address - Fax:888-268-1042
Practice Address - Street 1:5409 WHITE BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-9336
Practice Address - Country:US
Practice Address - Phone:336-644-9661
Practice Address - Fax:888-268-1042
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5548225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic