Individual
TAMARA LEIGH WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
222 FRONT ST, FAIRBANKS, AK 99701-3145
(907) 451-7100
Mailing address
222 FRONT ST, FAIRBANKS, AK 99701-3145
(907) 451-7100
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
66
AK
Other
Enumeration date
10/02/2007
Last updated
10/02/2007
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