Individual
NICOLE WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 VINE AVE, GREENVILLE, PA 16125-1314
(724) 588-2059
Mailing address
101 VINE AVE, GREENVILLE, PA 16125-1314
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06776
OH
Other
Enumeration date
11/13/2008
Last updated
11/13/2008
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