Provider Demographics
NPI:1437894821
Name:WEAVER, ZINA ZACCHEA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ZINA
Middle Name:ZACCHEA
Last Name:WEAVER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 LAUREL GLEN CIR APT 9
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-3689
Mailing Address - Country:US
Mailing Address - Phone:803-295-7620
Mailing Address - Fax:
Practice Address - Street 1:110 2ND ST SW STE 110
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-5250
Practice Address - Country:US
Practice Address - Phone:253-237-3405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-01
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10776225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist