Individual
JACK WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4505 E MCKELLIPS RD, MESA, AZ 85215-2523
(480) 641-6740
Mailing address
4505 E MCKELLIPS RD, MESA, AZ 85215-2523
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S00974
AZ
Other
Enumeration date
08/18/2014
Last updated
08/18/2014
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