Search › Virginia › 390200000X
Jack Weaver
NPI 1770457228 · on the registry since 2025 · sole proprietor
Practice
- Address
- 5001 Gunpowder Rd
Fairfax, VA 22030 - Phone
- (571) 230-8525
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Also registered as
- 2255A2300X
- Licence states on file
- VA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-09-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia