Individual
MARY THERESA WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
475 IRVIN CT, DECATUR, GA 30030-1717
(404) 299-1581
(404) 299-1581
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
(800) 944-9782
(610) 438-2046
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011007
GA
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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