Individual
ISABEL J WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19685 JOHNSON RD, SOUTH BEND, IN 46614-5440
(574) 386-4010
Mailing address
12347 DIAMOND DR, PLYMOUTH, IN 46563-8614
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007378A
IN
Other
Enumeration date
04/17/2024
Last updated
04/17/2024
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