Provider Demographics
NPI:1740369339
Name:WEBER, MICHAEL DENNIS (PT, DPT, MS, OCS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DENNIS
Last Name:WEBER
Suffix:
Gender:M
Credentials:PT, DPT, MS, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:16 SCORTON MARSH RD
Mailing Address - Street 2:
Mailing Address - City:E SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-1256
Mailing Address - Country:US
Mailing Address - Phone:508-833-2145
Mailing Address - Fax:508-833-2145
Practice Address - Street 1:439 STATION AVE
Practice Address - Street 2:
Practice Address - City:S YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-1849
Practice Address - Country:US
Practice Address - Phone:508-394-3333
Practice Address - Fax:508-394-3350
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50892251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic