Individual
MISS KRISTEN FRANCES WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
130 KAUFMAN DR, FAIRMONT, WV 26554-2179
(304) 363-4891
Mailing address
RR 3 BOX 377, GRAFTON, WV 26354-9566
(304) 612-4825
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1433
WV
Other
Enumeration date
11/10/2011
Last updated
11/10/2011
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