Organization
MARTIN D WEAVER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN D WEAVER (OWNER)
(215) 545-5404
Entity
Organization
Contact information
Practice address
21 S 12TH ST, STE 1000, FLOOR 10, PHILADELPHIA, PA 19107-3614
(215) 545-5404
Mailing address
21 S 12TH ST, STE 1000, FLOOR 10, PHILADELPHIA, PA 19107-3614
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
MD042968L
PA
Other
Enumeration date
01/06/2011
Last updated
01/06/2011
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