Individual
MICHAEL WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
1501 CRAWFORD AVE, ALTOONA, PA 16602-4605
(814) 931-3402
Mailing address
1501 CRAWFORD AVE, ALTOONA, PA 16602-4605
(814) 931-3402
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018703000003
—
PA
Enumeration date
08/01/2007
Last updated
08/01/2007
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