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General NPI Number Information
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NPI Number | 1477448645
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Entity Type | Individual
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Provider Name | WALTER WEAVER
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Gender | Male
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 1201 HIGHWAY 49 S STE 2
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City | RICHLAND
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State | MS
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Zip | 39218-9438
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Country | US
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Telephone | 769-251-1825
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 CORPORATE DR STE 400
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City | HOOVER
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State | AL
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Zip | 35242-5424
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Country | US
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Telephone | 423-702-4389
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT7990
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License Number State | MS
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