Individual
RENEE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-3952
Mailing address
13820 WATERVIEW TRL, GRAND HAVEN, MI 49417-8427
(616) 635-5609
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1973-919AT
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1973-919AT
LOUISIANA OPTOMETRY LICENSE NUMBER
LA
Enumeration date
08/02/2022
Last updated
08/02/2022
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