| Mackenzie Weisman, DPT | |
|
913 11th St Se, Bandon, OR 97411-9168 | |
| (541) 347-4314 | |
| Not Available |
| Full Name | Mackenzie Weisman |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 913 11th St Se, Bandon, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215612072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 13066 (Minnesota) | Secondary |
| 225100000X | Physical Therapist | 65015 (Oregon) | Primary |
| Provider Name | Multicare Health System |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1497766638 PECOS PAC ID: 7719899897 Enrollment ID: O20031105000760 |
| Mailing Address | Practice Location Address |
|---|---|
| Mackenzie Weisman, DPT 1771 Valley Ridge Pl, Chanhassen, MN 55317-8416 Ph: (952) 484-9276 | Mackenzie Weisman, DPT 913 11th St Se, Bandon, OR 97411-9168 Ph: (541) 347-4314 |
Paul Edward Smith, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 913 11th St Se Ste 2, Bandon, OR 97411 Phone: 541-347-4314 | |
Mrs. Courtney V Hiebing, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 913 11th St Se Ste 1, Bandon, OR 97411 Phone: 541-347-4314 | |
Mr. Tristan Proett, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 913 11th St Se, Suite 1, Bandon, OR 97411 Phone: 541-347-4314 Fax: 541-347-8006 | |
Nicolette Fonseca, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 913 11th St Se Ste 2, Bandon, OR 97411 Phone: 541-347-4314 Fax: 541-347-8006 |