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NPI Code Detail

MEDICARE: MS. SARAH LOUISE WEAVER NCTMB

MEDICARE: MS. SARAH LOUISE WEAVER NCTMB
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
1225700000XMassage Therapist

General Provider Information

NPI Number : 1528141595
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SARAH LOUISE WEAVER NCTMB
Provider Business Mailing Address
First Line : 2501 W 84TH ST
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55431-1602
Country : US
Telephone Number : 952-888-4777
Fax Number : 952-886-7561
Provider Business Practice Location Address
First Line : 2501 W 84TH ST
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55431-1602
Country : US
Telephone Number : 952-888-4777
Fax Number : 952-886-7561
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 07/08/2007

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Directions to “ MS. SARAH LOUISE WEAVER NCTMB” Practice Location

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