Provider Demographics
NPI:1336186527
Name:WEIMER, CRAIG A (DC,CCSP)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:A
Last Name:WEIMER
Suffix:
Gender:M
Credentials:DC,CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PINE TREE LN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-8129
Mailing Address - Country:US
Mailing Address - Phone:724-557-5575
Mailing Address - Fax:
Practice Address - Street 1:86 W FAYETTE ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3254
Practice Address - Country:US
Practice Address - Phone:724-437-4020
Practice Address - Fax:724-437-2717
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004243L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA194568OtherBC/BS
PA201728OtherUPMC
PA0011955880002Medicaid
PA201728OtherUPMC
PAU01362Medicare UPIN