Priscilla Ann Weaver, D.P.T
Individual provider Active NPI Physical Therapist · Edwards, IL
NPI 1033249362 · NPPES record last updated Jan 17, 2013
Key facts
- NPI
- 1033249362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070016907 (IL)
- Practice address
- 6823 N Iron Wood Dr
Edwards, IL 61528-9420 - Phone
- (239) 220-1342
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070016907 | IL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070016907 | IL | Yes |
Addresses
Primary practice location
6823 N Iron Wood Dr
Edwards, IL 61528-9420
Mailing address
6823 N Iron Wood Dr
Edwards, IL 61528-9420
Phone (239) 220-1342
Other providers in Edwards, IL
- Catherine Ann Schneider
- Thomas Terrell III
- Pierre Trad
- Way to Grow Pediatric Therapy Inc
- John P Weaver
All providers in Edwards, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.