Provider Demographics
NPI:1518787571
Name:WEIKLE, LARRY
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:
Last Name:WEIKLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 CUTNAW RD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:OH
Mailing Address - Zip Code:44822-9705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1825 CUTNAW RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:OH
Practice Address - Zip Code:44822-9705
Practice Address - Country:US
Practice Address - Phone:740-485-5019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle