Provider Demographics
NPI:1295890424
Name:WESTON, ERIK R (DC)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:R
Last Name:WESTON
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 1:63 EAGLE POINT DR
Mailing Address - Street 2:
Mailing Address - City:EDDYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42038-7636
Mailing Address - Country:US
Mailing Address - Phone:270-908-2500
Mailing Address - Fax:270-969-2808
Practice Address - Street 1:403 W FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:EDDYVILLE
Practice Address - State:KY
Practice Address - Zip Code:42038-8259
Practice Address - Country:US
Practice Address - Phone:270-908-2500
Practice Address - Fax:270-969-2808
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04745111N00000X
KY272684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ064886Medicare ID - Type Unspecified
NJU59673Medicare UPIN