Provider Demographics
NPI:1336682061
Name:R E WEAVER INC
Entity Type:Organization
Organization Name:R E WEAVER INC
Other - Org Name:APEX SPINE AND PERFORMANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-607-9272
Mailing Address - Street 1:801 POLARIS PKWY APT 409
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-2409
Mailing Address - Country:US
Mailing Address - Phone:740-607-9272
Mailing Address - Fax:
Practice Address - Street 1:801 POLARIS PKWY APT 409
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-2409
Practice Address - Country:US
Practice Address - Phone:740-607-9272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty