Provider Demographics
NPI:1649359738
Name:WEED, GERALD M JR (DC)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:M
Last Name:WEED
Suffix:JR
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 1:1640 BROOKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-9732
Mailing Address - Country:US
Mailing Address - Phone:484-788-0101
Mailing Address - Fax:484-788-0104
Practice Address - Street 1:1640 BROOKSIDE RD
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-9732
Practice Address - Country:US
Practice Address - Phone:484-788-0101
Practice Address - Fax:484-788-0104
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009179111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor