MEDICARE: JOHN WEBBER JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	14847	CT

General Provider Information

NPI Number	:	1649754086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN WEBBER JR.

Provider Business Mailing Address
First Line	:	2076 HWY 42 WEST
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27520
Country	:	US
Telephone Number	:	919-763-1050
Fax Number	:	919-313-1276

Provider Business Practice Location Address
First Line	:	3A CANDLEWOOD HILL RD
Second Line	:
City	:	HIGGANUM
State	:	CT
Zip	:	06441-4202
Country	:	US
Telephone Number	:	860-345-2622
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2018
Last Update Date	:	11/21/2025

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