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General NPI Number Information
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NPI Number | 1366320608
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Entity Type | Individual
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Provider Name | NICHOLAS WEISHAR
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Gender | Male
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 210 VILLAGE CENTER BLVD STE 100
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City | MYRTLE BEACH
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State | SC
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Zip | 29579-6706
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Country | US
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Telephone | 843-353-3460
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Fax | 843-353-3461
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Provider Business Mailing Address
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Address Line | N3957 LILLY RD
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City | RUBICON
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State | WI
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Zip | 53078-9771
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305217384
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 14116
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP053045T
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License Number State | SC
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