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General NPI Number Information
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NPI Number | 1427982081
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Entity Type | Individual
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Provider Name | PHILIP WEAVER
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Gender | Male
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 2092 W PENN PIKE
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City | NEW RINGGOLD
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State | PA
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Zip | 17960-9398
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Country | US
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Telephone | 570-645-1515
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Fax | 570-645-1514
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Provider Business Mailing Address
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Address Line | 2092 W PENN PIKE
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City | NEW RINGGOLD
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State | PA
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Zip | 17960-9398
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Country | US
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Telephone | 570-645-1515
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Fax | 570-645-1514
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | TEI003499
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License Number State | PA
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