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NPI Code Detail

MEDICARE: DR. CARRIE WEEDMAN P.T.

MEDICARE: DR. CARRIE WEEDMAN P.T.
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
1225100000XPhysical TherapistLPT-010821AZ
2225100000XPhysical Therapist6023SC
3225100000XPhysical Therapist10821AZ

General Provider Information

NPI Number : 1891928768
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARRIE WEEDMAN P.T.
Provider Business Mailing Address
First Line : 5605 W EUGIE AVE STE 212
Second Line :
City : GLENDALE
State : AZ
Zip : 85304-1275
Country : US
Telephone Number : 480-210-6445
Fax Number : 480-795-6160
Provider Business Practice Location Address
First Line : 5605 W EUGIE AVE STE 212
Second Line :
City : GLENDALE
State : AZ
Zip : 85304-1275
Country : US
Telephone Number : 480-210-6445
Fax Number : 480-795-6160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2009
Last Update Date : 02/07/2025

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