Individual
JUSTIN LEE WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PROVIDER
Contact information
Practice address
904 ORCHARDGLOW CLOSE, FAIRFIELD, OH 45014-3164
(513) 600-9170
Mailing address
904 ORCHARDGLOW CLOSE, FAIRFIELD, OH 45014-3164
(513) 600-9170
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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