Individual
MRS. LISA M WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6450 US HIGHWAY 6, PORTAGE, IN 46368-5110
(219) 763-8112
(219) 764-6348
Mailing address
6450 US HIGHWAY 6, PORTAGE, IN 46368-5110
(219) 763-8112
(219) 764-6348
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28157609A
IN
Other
Enumeration date
11/10/2006
Last updated
07/08/2007
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