Individual
MR. JIMMY WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
318 WEST MAIN STREET, BOX 1208, BOISE CITY, OK 73933-1208
(580) 544-3441
(580) 544-3440
Mailing address
318 WEST MAIN STREET, BOX 1208, BOISE CITY, OK 73933-1208
(580) 544-3441
(580) 544-3440
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7827
OK
Other
Enumeration date
10/05/2006
Last updated
07/09/2007
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