Individual
LAURIE ELAINE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
1050 DELAWARE AVENUE, MARION, OH 43302
(740) 383-8022
(740) 383-7942
Mailing address
PO BOX 1827, MARION, OH 43301-1827
(740) 383-8022
(740) 383-7942
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT010063
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000242859
ANTHEM
OH
05
—
2369011
—
OH
01
—
311704991
UNITED MINEWORKERS OF AM
—
01
—
650024871
TRAVELERS MEDICARE
—
Enumeration date
05/03/2006
Last updated
10/29/2009
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