Individual
LEE PONO-NALU WEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
225 N WILLOW AVE, COOKEVILLE, TN 38501-2335
(931) 528-8899
Mailing address
225 N WILLOW AVE, COOKEVILLE, TN 38501-2335
(931) 528-8899
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1838
TN
207Q00000X
Family Medicine Physician
20A8737
CA
Other
Enumeration date
10/30/2008
Last updated
10/29/2016
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