PHILIP WEIVODA

TUPELO, MS
NPI1588329775
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MS  AT0731)
Enumeration Date2021-11-03
Last Update Date2021-11-03
Business Address
PHILIP WEIVODA ATC
235 ROAD 1399
TUPELO, MS 38804-7537
Phone number: 503-351-6211
Mailing Address
PHILIP WEIVODA ATC
235 ROAD 1399
TUPELO, MS 38804-7537
Phone number:
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