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Individual
LAUREN WEAVER
Active
Individual
LAUREN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
CP053719T
SC
2251X0800X
Orthopedic Physical Therapist
011209
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP7913
MEDICARE GROUP NUMBER
GA
01
—
PT011209
LICENSE NUMBER
GA
Enumeration date
09/05/2013
Last updated
05/06/2026
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