| Doctor Name: | NICHOLAS WEBER |
| NPI Number: | 1063466019 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MPT |
| License Number: | 2005017285 |
| Business Practice Address: | 4800 Mexico Rd Suite 104 Saint Peters, MO - 633761666 |
| Business Phone Number: | 6369399540 |
| Business Fax Number: | 6369399886 |
| Mailing Address: | 607 Dewey Ave Nw, Ste 300 GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495047335 |
| Phone Number: | 6163565000 |
| Fax Number: | 6163565001 |
| NPI Enumeration Date: | 05/22/2006 |
| NPI Last Update Date: | 05/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2005017285 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |