Individual
BRIAN WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
1139 ADDISON AVE E, TWIN FALLS, ID 83301-5224
(208) 734-2660
(208) 736-3872
Mailing address
1139 ADDISON AVE E, TWIN FALLS, ID 83301-5224
(208) 734-2660
(208) 736-3872
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5991
ID
Other
Enumeration date
10/05/2007
Last updated
10/05/2007
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