Provider Demographics
NPI:1790360154
Name:SARA C. WEYER - WEYER CHIROPRACTIC
Entity Type:Organization
Organization Name:SARA C. WEYER - WEYER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-836-5671
Mailing Address - Street 1:3316 CHIQUITA BLVD S
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-5120
Mailing Address - Country:US
Mailing Address - Phone:678-836-5671
Mailing Address - Fax:
Practice Address - Street 1:3316 CHIQUITA BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-5120
Practice Address - Country:US
Practice Address - Phone:239-800-5197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00000000Medicaid