Individual
MR. SEAN R WEATHERSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
211 E LOGAN ST, SUITE 101, CALDWELL, ID 83605-4835
(208) 454-9839
(208) 454-0727
Mailing address
2101 W GROUSE ST, NAMPA, ID 83651-8353
(208) 465-8087
(208) 454-0727
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1523
ID
Other
Enumeration date
11/22/2005
Last updated
12/04/2007
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