Individual
JUDY WEATHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
351 ROSE AVE, SABINA, OH 45169-1243
(937) 584-9631
Mailing address
351 ROSE AVE, SABINA, OH 45169-1243
(937) 584-9631
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2691430
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2691430
—
OH
Enumeration date
03/14/2007
Last updated
07/09/2007
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