MEDICARE: WEIR WELLNESS, P.C.

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	111N00000X	Chiropractor	1226	NC

General Provider Information

NPI Number	:	1952607913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEIR WELLNESS, P.C.

Provider Business Mailing Address
First Line	:	4109 WAKE FOREST RD
Second Line	:	SUITE 102
City	:	RALEIGH
State	:	NC
Zip	:	27609-2510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4109 WAKE FOREST RD
Second Line	:	SUITE 102
City	:	RALEIGH
State	:	NC
Zip	:	27609-2510
Country	:	US
Telephone Number	:	919-790-1332
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TIMOTHY WEIR
Credential	:	DC
Telephone Number	:	919-279-5309

Provider Enumeration Date	:	02/08/2011
Last Update Date	:	03/22/2011

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Directions to “WEIR WELLNESS, P.C. ” Practice Location

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