Individual
MARISSA A WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2895 HAMILTON BLVD, SUITE 104, ALLENTOWN, PA 18104-6172
(610) 435-8986
(610) 435-8307
Mailing address
2895 HAMILTON BLVD, SUITE 104, ALLENTOWN, PA 18104-6172
(610) 435-8986
(610) 435-8307
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA054108
PA
Other
Enumeration date
09/03/2009
Last updated
01/27/2010
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