Individual
MR. FRED C WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTC
Contact information
Practice address
304 S PARK LN, SUITE A, ALTUS, OK 73521-5718
(580) 477-7356
(580) 482-7510
Mailing address
304 S PARK LN, SUITE A, ALTUS, OK 73521-5718
(580) 477-7356
(580) 482-7510
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
87-0658
OK
Other
Enumeration date
07/05/2007
Last updated
07/08/2007
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