Individual
MR. GREGORY ALLEN WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
520 S MAPLE AVE, OAK PARK, IL 60304
(708) 660-3800
Mailing address
520 S MAPLE AVE, OAK PARK, IL 60304
(708) 660-3800
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.004026
IL
Other
Enumeration date
12/19/2012
Last updated
12/19/2012
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