Provider Demographics
NPI:1770133217
Name:WEAVER CONSULTATION PARTNERS, LLC
Entity type:Organization
Organization Name:WEAVER CONSULTATION PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAGEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-610-1081
Mailing Address - Street 1:61 OLD TAVERN CIR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-7753
Mailing Address - Country:US
Mailing Address - Phone:434-610-1081
Mailing Address - Fax:
Practice Address - Street 1:1890 NORTHWEST BLVD STE 140
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-1637
Practice Address - Country:US
Practice Address - Phone:614-515-6291
Practice Address - Fax:617-454-4960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental HealthGroup - Multi-Specialty