Provider Demographics
NPI:1760427066
Name:WEAVER PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:WEAVER PHYSICAL THERAPY, LLC
Other - Org Name:IN SYNC REHABILITATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BROCK
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:724-532-3422
Mailing Address - Street 1:3960 ROUTE 30
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-5518
Mailing Address - Country:US
Mailing Address - Phone:724-532-3422
Mailing Address - Fax:724-532-3424
Practice Address - Street 1:3960 ROUTE 30
Practice Address - Street 2:SUITE 104
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-5518
Practice Address - Country:US
Practice Address - Phone:724-532-3422
Practice Address - Fax:724-532-3424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA826724OtherHIGHMARK BC BS PT
116772OtherHEALTH ASSURANCE/AMERICA
PA1472545OtherHIGHMARK BC BS OT
PA541068OtherHIGHMARK BC BS SLP
0619112OtherAETNA
9841133OtherCIGNA
0619112OtherAETNA