Provider Demographics
NPI:1356606297
Name:WEISS NEURO THERAPY & WELLNESS
Entity type:Organization
Organization Name:WEISS NEURO THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MPT, MSCS
Authorized Official - Phone:210-573-1386
Mailing Address - Street 1:1542 BENTON WOODS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4494
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1542 BENTON WOODS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4494
Practice Address - Country:US
Practice Address - Phone:210-573-1386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-06
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service