Individual
KAYLA WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3320 OLD JEFFERSON RD, ATHENS, GA 30607-1400
(706) 613-1625
Mailing address
3320 OLD JEFFERSON RD, ATHENS, GA 30607-1400
(706) 613-1625
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6039
GA
Other
Enumeration date
01/05/2011
Last updated
09/23/2021
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