Individual
KEITH ALAN WEATHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 KINGS CT, UKIAH, CA 95482-5003
(707) 468-7700
Mailing address
630 KINGS CT, UKIAH, CA 95482-5003
(707) 391-6296
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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