Tegan Renee Weaver

NPI #1780149286 in West Melbourne, Florida

Provider Information

NPI Number: 1780149286
Entity Type: Individual
Name: Tegan Renee Weaver
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Feb 8, 2019
Last Updated: Feb 8, 2019

Practice Location

Address: 2381 STRATFORD POINTE DR
City: West Melbourne
State: Florida
ZIP Code: 32904-8054
Phone: (321) 505-3158

Specialties & Taxonomy Codes

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

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