Blaine A Weaver

NPI #1003457706 in West Portsmouth, Ohio

Provider Information

NPI Number: 1003457706
Entity Type: Individual
Name: Blaine A Weaver
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Oct 3, 2019
Last Updated: Oct 3, 2019

Practice Location

Address: 48 DRY RUN RD
City: West Portsmouth
State: Ohio
ZIP Code: 45663-8987
Phone: (740) 285-4724

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X

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