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1063559631
DERWIN LEWIS WISON
CARROLLTON, TX
NPI
1063559631
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date
2007-01-31
Last Update Date
2007-07-08
Business Address
Mr. DERWIN LEWIS WISON
3640 OLD DENTON RD APT 1803
CARROLLTON, TX 75007-7944
Phone number: 817-996-7456
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Mailing Address
Mr. DERWIN LEWIS WISON
3640 OLD DENTON RD APT 1803
CARROLLTON, TX 75007
Phone number: 817-996-7456
Copy
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