Healthcare Provider Details

I. General information

NPI: 1609988286
Provider Name (Legal Business Name): JOHN ERNEST WEISBERG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 S. 16TH ST.
WILMINGTON NC
28401
US

IV. Provider business mailing address

1375 S. 16TH ST.
WILMINGTON NC
28401
US

V. Phone/Fax

Practice location:
  • Phone: 910-352-2723
  • Fax: 910-343-1178
Mailing address:
  • Phone: 910-352-2723
  • Fax: 910-343-1178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1371
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberX-003440-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: