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NPI Code Detail

MEDICARE: MR. BILLY HUGH WEAVER OTR/L

MEDICARE: MR. BILLY HUGH WEAVER OTR/L
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
1225X00000XOccupational Therapist01772IA

General Provider Information

NPI Number : 1477576841
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BILLY HUGH WEAVER OTR/L
Provider Business Mailing Address
First Line : 701 10TH ST SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52403-1292
Country : US
Telephone Number : 319-398-6011
Fax Number :
Provider Business Practice Location Address
First Line : 701 10TH ST SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52403-1292
Country : US
Telephone Number : 319-398-6011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 04/11/2018

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Directions to “ MR. BILLY HUGH WEAVER OTR/L” Practice Location

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