Individual
JOHN F. WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
205 VALLEY AVE, WEST BEND, WI 53095-5312
(262) 338-1123
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2573
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38631100
—
WI
Enumeration date
11/03/2006
Last updated
01/26/2025
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