Individual
MS. LUCINDA WEAVER I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T.
Contact information
Practice address
39120 OCEAN DR., GUALALA, CA 95445
(707) 884-4800
(707) 884-4808
Mailing address
PO BOX 1441, GUALALA, CA 95445-1441
(707) 884-4800
(707) 884-4808
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
014743-1
NY
2251S0007X
Sports Physical Therapist
PT20541
CA
2251X0800X
Orthopedic Physical Therapist
014743-1
NY
2251X0800X
Orthopedic Physical Therapist
Primary
PT20541
CA
Other
Enumeration date
01/30/2009
Last updated
10/16/2020
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