Individual
JACOB THOMAS WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 LINCOLN AVE, EAST STROUDSBURG, PA 18301-2815
(570) 476-8834
Mailing address
300 LINCOLN AVE, EAST STROUDSBURG, PA 18301-2815
(570) 476-8834
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP453612
PA
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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