Provider Demographics
NPI:1255813200
Name:WEISKOPF, ISABELLA (LAT, ATC)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:WEISKOPF
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15447 HARRISBERG CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-1933
Mailing Address - Country:US
Mailing Address - Phone:636-489-9464
Mailing Address - Fax:
Practice Address - Street 1:1504 KATHLEEN ST APT 1802
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-9453
Practice Address - Country:US
Practice Address - Phone:870-972-3342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer