Healthcare Provider Details

I. General information

NPI: 1619255965
Provider Name (Legal Business Name): GUY L WEYER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 4TH AVE SW STE 1
ABERDEEN SD
57401-4133
US

IV. Provider business mailing address

121 4TH AVE SW SUITE 1
ABERDEEN SD
57401-4133
US

V. Phone/Fax

Practice location:
  • Phone: 605-725-3277
  • Fax: 605-725-3278
Mailing address:
  • Phone: 605-725-3277
  • Fax: 605-725-3278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MR. GUY L WEYER
Title or Position: OWNER/MANAGER
Credential:
Phone: 605-725-3277