Individual
MR. JARED JEREL WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAREGIVER
Contact information
Practice address
210 FOXLAKE DR, STATESBORO, GA 30458-4400
(912) 536-6679
(912) 536-6679
Mailing address
210 FOXLAKE DR, STATESBORO, GA 30458-4400
(912) 536-6679
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
GA
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
06/12/2020
Last updated
12/02/2020
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