Individual
MR. BROCK ANDREW WEAVER
Active
Individual
MR. BROCK ANDREW WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
DAPT002756
PA
225100000X
Physical Therapist
PT020931
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007683490007
—
PA
05
—
1025442830002
—
PA
01
—
826724
HIGHMARK BC/BS
PA
Enumeration date
11/16/2010
Last updated
10/15/2019
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