Individual
COURTNEY D WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9640 GULL LAKE DR, INDIANAPOLIS, IN 46239-6892
(765) 667-7988
Mailing address
9640 GULL LAKE DR, INDIANAPOLIS, IN 46239-6892
(765) 667-7988
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
415262955
IN
Other
Enumeration date
04/08/2026
Last updated
04/08/2026
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