Provider Demographics
NPI:1801612700
Name:WEIRICK, BRYAN EDWARD
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:EDWARD
Last Name:WEIRICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 COUNTY ROAD 1095
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-9401
Mailing Address - Country:US
Mailing Address - Phone:419-651-2250
Mailing Address - Fax:
Practice Address - Street 1:1777 COUNTY ROAD 1095
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-9401
Practice Address - Country:US
Practice Address - Phone:419-651-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle