Matthew Caleb Weaver

NPI #1255719092 in Boise, Idaho

Provider Information

NPI Number: 1255719092
Entity Type: Individual
Name: Matthew Caleb Weaver
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: May 13, 2015
Last Updated: May 13, 2015

Practice Location

Address: 300 S 23RD ST
City: Boise
State: Idaho
ZIP Code: 83702-9100
Phone: (208) 345-1170

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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