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1184055048
JACK WEAVER
FORT PAYNE, AL
NPI
1184055048
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: AL C2207A)
Enumeration Date
2013-12-03
Last Update Date
2013-12-03
Business Address
Mr. JACK WEAVER ALC
521 GAULT AVE N
FORT PAYNE, AL 35967-2307
Phone number: 256-273-7216
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Mailing Address
Mr. JACK WEAVER ALC
521 GAULT AVE N
FORT PAYNE, AL 35967-2307
Phone number: 256-273-7216
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