Individual
MR. ROLAND WEATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4218 N GRAND BLVD, SAINT LOUIS, MO 63107-1806
(314) 534-6624
(314) 535-4394
Mailing address
4220 N GRAND BLVD, SAINT LOUIS, MO 63107-1804
(314) 534-6624
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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