Individual
HEATHER A WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
890 LAZELLE ST, STURGIS, SD 57785-1611
(605) 347-3616
Mailing address
PO BOX 3450, RAPID CITY, SD 57709-3450
(605) 347-3616
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1250
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5834422
—
SD
Enumeration date
10/05/2006
Last updated
07/08/2007
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