Individual
CARISSA D WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
RR 3 BOX 308, ALBION, IL 62806-9586
(618) 445-3660
Mailing address
RR 3 BOX 308, ALBION, IL 62806-9586
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.004269
IL
Other
Enumeration date
09/12/2008
Last updated
09/12/2008
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