JAMES RANDALL DEATHERAGE

BREWTON, AL
NPI1265543797
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: AL  4913)
Enumeration Date2006-08-31
Last Update Date2007-07-08
Business Address
JAMES RANDALL DEATHERAGE
422 DOUGLAS AVENUE
BREWTON, AL 36426
Phone number: 251-867-6837
Mailing Address
JAMES RANDALL DEATHERAGE
422 DOUGLAS AVENUE
BREWTON, AL 36426
Phone number: 251-867-6837