Healthcare Provider Details

I. General information

NPI: 1730029273
Provider Name (Legal Business Name): MASON M WEBER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S FRANKLIN ST
MOUNT PLEASANT MI
48859-2001
US

IV. Provider business mailing address

7262 S SUMMERTON RD
SHEPHERD MI
48883-9399
US

V. Phone/Fax

Practice location:
  • Phone: 989-430-3999
  • Fax:
Mailing address:
  • Phone: 989-430-3999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: