Individual
AMY WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
N14W23900 STONE RIDGE DR, PROHEALTH CARE MEDICAL ASSOCIATES, WAUKESHA, WI 53188-1135
(262) 549-3030
(262) 574-7833
Mailing address
4805 S MOORLAND RD, F&MCW COMMUNITY PHYSICIANS MOORLAND RESERVE, NEW BERLIN, WI 53151-7401
(262) 798-7200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2572
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38597800
—
WI
Enumeration date
04/25/2006
Last updated
05/12/2014
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