Individual
KELLY MICHELLE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM. D
Contact information
Practice address
137 S MAIN ST, DYER, TN 38330-1815
(731) 692-3578
(731) 692-4219
Mailing address
287 N POPLAR ST, DYER, TN 38330-1105
(731) 692-3851
(731) 692-4219
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21792
TN
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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