Individual
EDWARD GLENN WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
800 GRAND CENTRAL MALL, SUITE 1, VIENNA, WV 26105-4100
(304) 865-6777
(304) 865-6780
Mailing address
415 36TH ST, SUITE 100, PARKERSBURG, WV 26101-1005
(304) 917-3660
(304) 917-3674
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001333
WV
225100000X
Physical Therapist
PT006713
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2702614
—
OH
05
—
7305220000
—
WV
01
—
P00123835
RAILROAD MEDICARE
—
Enumeration date
08/12/2006
Last updated
05/27/2016
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