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NPI Code Detail

MEDICARE: MARC DANIEL WEISHAAR DSC, PT

MEDICARE: MARC DANIEL WEISHAAR DSC, PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical TherapistPTL.0008829CO
2225100000XPhysical Therapist1297156TX

General Provider Information

NPI Number : 1538329289
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARC DANIEL WEISHAAR DSC, PT
Provider Business Mailing Address
First Line : PO BOX 5730
Second Line :
City : BELFAST
State : ME
Zip : 04915-5700
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4700 LAS VEGAS BLVD N
Second Line :
City : NELLIS AFB
State : NV
Zip : 89191-6600
Country : US
Telephone Number : 702-653-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2008
Last Update Date : 06/09/2026

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