Individual
JOSHUA DAVID WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
11112 PACIFIC AVE S, TACOMA, WA 98444-5749
(253) 537-1103
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501014153
MI
225100000X
Physical Therapist
Primary
PT60051171
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0329317
WA L&I
WA
05
—
1710131032
—
WA
05
—
2006102
—
WA
01
—
5501014153
MI LICENSE
MI
Enumeration date
11/13/2008
Last updated
02/05/2016
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