DR. Jackie Lynn Weaver, DC, PHARM D

NPI #1720072523 in Tyler, Texas

Provider Information

NPI Number: 1720072523
Entity Type: Individual
Name: DR. Jackie Lynn Weaver, DC, PHARM D
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Chiropractor
Credential: DC, PHARM D
Enumeration Date: Sep 7, 2005
Last Updated: Jan 19, 2017

Practice Location

Address: 2726 W GENTRY PKWY
City: Tyler
State: Texas
ZIP Code: 75702-1635
Phone: (903) 593-2533

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary
Pharmacist	183500000X

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