Individual
MR. MIKE WEAVER
Active
Individual
MR. MIKE WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CTRS
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
273Y00000X
Rehabilitation Hospital Unit
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
Other
Enumeration date
08/01/2006
Last updated
09/04/2009
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