Basic Information
| Provider Information | |||||||||
| NPI: | 1477858686 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEIBLE | ||||||||
| FirstName: | KIRSTIN | ||||||||
| MiddleName: | JOY | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10550 N LA CANADA DR | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857377130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5205472476 | ||||||||
| FaxNumber: | 5205472480 | ||||||||
| Practice Location | |||||||||
| Address1: | 10550 N LA CANADA DR | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857377130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5205472476 | ||||||||
| FaxNumber: | 5205472480 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2011 | ||||||||
| LastUpdateDate: | 08/07/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 12934 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.