Individual
SUSAN WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1392 YALE DR, BRUNSWICK, OH 44212-3543
(216) 538-9350
Mailing address
1392 YALE DR, BRUNSWICK, OH 44212-3543
(216) 538-9350
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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