Individual
MR. BROCK ANDREW WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3960 ROUTE 30 STE 104, LATROBE, PA 15650-5518
(724) 532-3422
(724) 532-3424
Mailing address
3960 ROUTE 30, SUITE 104, LATROBE, PA 15650-5518
(724) 532-3422
(724) 532-3424
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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