Individual
KAITLAN BRYANT WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
125 PROFESSIONAL PARK DR, SENECA, SC 29678-2558
(864) 482-3000
(864) 482-4000
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
1207410
SC
363AM0700X
Medical Physician Assistant
Primary
5398
SC
Other
Enumeration date
06/19/2024
Last updated
09/10/2024
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