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Individual

MRS. MIKAYLA ROSE WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHDHP

Contact information

Practice address
471 HEPBURN ST, WILLIAMSPORT, PA 17701-6122
(570) 567-5400
Mailing address
441 MAIN ST, SALLADASBURG, PA 17740-7409
(814) 221-3592

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH075247
PA

Other

Enumeration date
07/15/2025
Last updated
12/22/2025
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