Healthcare Provider Details

I. General information

NPI: 1659552867
Provider Name (Legal Business Name): GERALD R WEIS DC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 04/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10671 MCSWAIN DRIVE
CINCINNATI OH
45241-3168
US

IV. Provider business mailing address

10671 MCSWAIN DRIVE
CINCINNATI OH
45241-3168
US

V. Phone/Fax

Practice location:
  • Phone: 513-563-0414
  • Fax: 513-563-9540
Mailing address:
  • Phone: 513-563-0414
  • Fax: 513-563-9540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1009
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number1009
License Number StateOH

VIII. Authorized Official

Name: DR. JOSEPH P FINUCAN
Title or Position: PRESIDENT CEO
Credential: DC CCSP
Phone: 513-563-0414