Provider Demographics
NPI:1982405684
Name:WEIGANT, JOE (CMT)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:WEIGANT
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 SAINT PHILIP RD N
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712
Mailing Address - Country:US
Mailing Address - Phone:812-568-5356
Mailing Address - Fax:
Practice Address - Street 1:701 N WEINBACH AVE STE 310
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-5990
Practice Address - Country:US
Practice Address - Phone:812-568-5356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT22308192225700000X, 173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist