Individual
DANIEL TODD WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
251 COUNTY ROAD 120, SUITE A, SAINT CLOUD, MN 56303
(320) 259-5429
(320) 240-8905
Mailing address
1301 33RD ST S STE 210, SAINT CLOUD, MN 56301-9668
(320) 240-6955
(320) 240-8089
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6148
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133482000
—
MN
01
—
264M1NO
BLUE CROSS BLUE SHIELD OF MN
MN
01
—
6411228
MEDICA
MN
01
—
8B792WE
BLUE CROSS BLUE SHIELD
MN
01
—
HP43511
HEALTHPARTNERS
MN
Enumeration date
12/13/2006
Last updated
03/16/2023
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