Organization
BEYOND BOUNDARIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER WEAVER OTR/L (MEMBER)
(978) 302-9529
Entity
Organization
Contact information
Practice address
5550 PAINTED MIRAGE RD, SUITE 320, LAS VEGAS, NV 89149-4581
(702) 444-0774
(702) 834-3256
Mailing address
5550 PAINTED MIRAGE RD, SUITE 320, LAS VEGAS, NV 89149-4581
(702) 444-0774
(702) 834-3256
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT2971
NV
225X00000X
Occupational Therapist
14-0449
NV
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
14-0530
NV
Other
Enumeration date
06/22/2015
Last updated
07/14/2016
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