Individual
DALE R WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 SOUTH THIRD ST., CONNEAUT LAKE, PA 16316-1108
(814) 382-2380
(814) 382-8218
Mailing address
100 S. THIRD ST., PO BOX 276, CONNEAUT LAKE, PA 16316-1108
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP031999L
PA
Other
Enumeration date
05/18/2011
Last updated
05/18/2011
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