Individual
MARTHA GOMEZ WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.N
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3811
(215) 707-3959
Mailing address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3811
(215) 707-3959
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN004035
PA
Other
Enumeration date
05/20/2010
Last updated
05/20/2010
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