Individual
PAMELA WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
8444 NW 39TH EXPY, BETHANY, OK 73008-3072
(405) 466-5568
Mailing address
PO BOX 115, BETHANY, OK 73008-0115
(405) 466-5568
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
173131
OK
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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