Individual
PROF. BRIAN JOSEPH WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D., M.B.A.
Contact information
Practice address
4419 N SHEFFIELD AVE, SHOREWOOD, WI 53211-1307
(262) 391-8112
Mailing address
17275 MORNINGVIEW CT, BROOKFIELD, WI 53045-4358
(262) 391-8833
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2800
WI
152W00000X
Optometrist
TPOP110
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38630700
—
WI
Enumeration date
09/06/2006
Last updated
03/06/2023
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