Basic Information
| Provider Information | |||||||||
| NPI: | 1902470743 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEHR | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 278 SMITHFIELD ST | ||||||||
| Address2: | |||||||||
| City: | DILLONVALE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439176801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1740317611 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 HALLORAN DRIVE | ||||||||
| Address2: | |||||||||
| City: | SAINT CLAIRSVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402965743 | ||||||||
| FaxNumber: | 7402965952 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2021 | ||||||||
| LastUpdateDate: | 05/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | OH | Y |
No ID Information.