Provider Demographics
NPI:1588978522
Name:WEBER-JASPER, TRISHA ANNE (DC)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANNE
Last Name:WEBER-JASPER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4135 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2628
Mailing Address - Country:US
Mailing Address - Phone:563-583-1539
Mailing Address - Fax:563-583-1518
Practice Address - Street 1:4135 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-2628
Practice Address - Country:US
Practice Address - Phone:563-583-1539
Practice Address - Fax:563-583-1518
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007335111N00000X
IL038011896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor