Individual
MARK L WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
317 N. FALER AVE, PINEDALE, WY 82941
(307) 367-6236
(307) 367-3332
Mailing address
PO BOX 1037, PINEDALE, WY 82941-1037
(307) 367-6236
(307) 367-3332
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-642
WY
Other
Enumeration date
01/19/2007
Last updated
11/17/2015
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