Individual
JEREMY ALLEN WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
1435 MCKINLEY ST, CANON CITY, CO 81212-4453
(719) 280-3020
Mailing address
1435 MCKINLEY ST, CANON CITY, CO 81212-4453
(719) 280-3020
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CO
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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