MEDICARE: CARSEN WEICHMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	16343	NC
2	225X00000X	Occupational Therapist	OT21905	FL

General Provider Information

NPI Number	:	1063091122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARSEN WEICHMAN

Provider Business Mailing Address
First Line	:	120 TOMAHAWK DR
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28117-9034
Country	:	US
Telephone Number	:	518-796-1845
Fax Number	:

Provider Business Practice Location Address
First Line	:	13910 HUNTON LN
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-6088
Country	:	US
Telephone Number	:	704-897-2872
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2021
Last Update Date	:	11/14/2024

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Directions to “ CARSEN WEICHMAN ” Practice Location

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