Basic Information
| Provider Information | |||||||||
| NPI: | 1982904710 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEISMER | ||||||||
| FirstName: | DAWN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 126 LAUREL TRL | ||||||||
| Address2: | |||||||||
| City: | WOOLWICH TOWNSHIP | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080854074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564673190 | ||||||||
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| Practice Location | |||||||||
| Address1: | 84 E GRANT ST | ||||||||
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| City: | WOODSTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080981400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567694564 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2010 | ||||||||
| LastUpdateDate: | 01/24/2013 | ||||||||
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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 | 40QA00885200 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.