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Individual

JOHN P WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6823 N IRON WOOD DR, EDWARDS, IL 61528-9420
(309) 645-2062
Mailing address
6823 N IRON WOOD DR, EDWARDS, IL 61528-9420
(309) 645-2062

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007581
IL

Other

Enumeration date
08/06/2016
Last updated
08/06/2016
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