# MARTIN D WEAVER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245534155
- **Authorized official:** MARTIN D WEAVER (OWNER)
- **Authorized official phone:** (215) 545-5404

## Contact information

- **Practice address:** 21 S 12TH ST, STE 1000, FLOOR 10, PHILADELPHIA, PA 19107-3614
- **Practice address phone:** (215) 545-5404
- **Mailing address:** 21 S 12TH ST, STE 1000, FLOOR 10, PHILADELPHIA, PA 19107-3614

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | MD042968L | PA | Yes |

## Other

- **Enumeration date:** 01/06/2011
- **Last updated:** 01/06/2011