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Individual

SAMANTHA WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR-L

Contact information

Practice address
243 WOODROW WILSON AVE, FISHERSVILLE, VA 22939-1500
(540) 332-7087
(540) 332-7006
Mailing address
PO BOX 1500, FISHERSVILLE, VA 22939-1500
(540) 332-7087

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119005649
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1629049143
VA
Enumeration date
05/14/2014
Last updated
05/14/2014
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