Healthcare Provider Details

I. General information

NPI: 1730514134
Provider Name (Legal Business Name): LAUREN WEAVER DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN PERRY

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 FOOTHILLS CENTER DR STE 148&150
WEST UNION SC
29696-2518
US

IV. Provider business mailing address

148 FOOTHILLS CENTER DR STE 148&150
WEST UNION SC
29696-2518
US

V. Phone/Fax

Practice location:
  • Phone: 864-638-6405
  • Fax: 864-638-6421
Mailing address:
  • Phone: 864-638-6405
  • Fax: 864-638-6421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number011209
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP053719T
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: