DR. MALLORY WEAVER, DO

Student in an Organized Health Care Education/Training Program

Active Individual
NPI: 1376235861

Practice Address

815 MAIN ST STE C
Peoria, IL 61602

Phone: (309) 672-4977

Specialties

Specialty Code Primary License
Student in an Organized Health Care Education/Training Program 390200000X Yes 90200000X ()

Frequently Asked Questions

NPI 1376235861 is the National Provider Identifier for DR. MALLORY WEAVER, DO, a Student in an Organized Health Care Education/Training Program provider located in Peoria, IL. This NPI was enumerated on May 23, 2023.
DR. MALLORY WEAVER, DO practices at 815 MAIN ST STE C, Peoria, IL 61602.

Quick Facts

NPI
1376235861
Type
Individual
Enumerated
May 23, 2023
Last Updated
May 23, 2023

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