Individual
KAYLA WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4350 US 421 S, LILLINGTON, NC 27546-6760
(910) 893-1210
Mailing address
804 OLEANDER ST, JACKSONVILLE, NC 28540-4377
(910) 581-2305
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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