Amanda Lynne Weidner, PT
Physical Therapist in Saint Clair Shores, MI. Individual provider (NPI-1).
NPI number1669973319
StatusActive
Last updated in NPPESFeb 27, 2018
Details
- NPI
- 1669973319
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Amanda Lynne Weidner
- Credential
- PT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 27, 2018
- Last updated
- Feb 27, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 5501012049 | MI | Yes |
Practice location
23715 Little Mack Ave Ste 200Saint Clair Shores, MI 48080-1181
Phone 586-447-4064 · Fax 586-447-4069
Mailing address
53581 Deerfield LnNew Baltimore, MI 48047-6395
Phone 586-292-6005
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 76 Physical Therapist providers in Saint Clair Shores · All 1,725 providers in Saint Clair Shores
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