Healthcare Provider Details

I. General information

NPI: 1346977782
Provider Name (Legal Business Name): PAUL H WEBER CO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 E MAIN ST
EASLEY SC
29640-3791
US

IV. Provider business mailing address

711 SALUDA DR STE A1
FLORENCE SC
29501-4578
US

V. Phone/Fax

Practice location:
  • Phone: 864-859-4709
  • Fax: 864-855-9331
Mailing address:
  • Phone: 843-804-4436
  • Fax: 843-799-1271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: