Individual
DESTINY NICOLE WEATHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
98 BRIGGS ST, SAN ANTONIO, TX 78224-1286
(210) 226-9536
Mailing address
11300 EXPO BLVD APT 1014, SAN ANTONIO, TX 78230-1333
(817) 456-2600
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2096703
TX
Other
Enumeration date
06/09/2014
Last updated
06/09/2014
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