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General NPI Number Information
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NPI Number | 1174596191
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Entity Type | Individual
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Provider Name | DEBORAH J WEATHERLY CPHT
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Gender | Female
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1325 E WOOD ST
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City | PARIS
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State | TN
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Zip | 38242-4421
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Country | US
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Telephone | 731-648-0451
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Fax |
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Provider Business Mailing Address
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Address Line | 840 WEATHERLY RD
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City | CAMDEN
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State | TN
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Zip | 38320-6473
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Country | US
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Telephone | 731-584-3747
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 0000016380
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License Number State | TN
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