Individual
POLLIE A WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3701 PORTAGE AVE, SOUTH BEND, IN 46628-6098
(574) 243-5849
Mailing address
2695 PORTAGE RD, NILES, MI 49120-8706
(269) 683-6670
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26017374A
IN
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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