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Individual

CORLANDRA LACRYSTAL WEAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2428 6TH ST E, TUSCALOOSA, AL 35404-3114
(205) 887-0799
Mailing address
2428 6TH ST E, TUSCALOOSA, AL 35404-3114
(205) 887-0799

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
9372691
AL
246RP1900X
Phlebotomy Technician
650418160035
AL
343900000X
Non-emergency Medical Transport (VAN)
Primary
9372691
AL

Other

Enumeration date
12/13/2022
Last updated
12/13/2022
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