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1366692246
DIANA M MANCUSO MD PA
DOTHAN, AL
NPI
1366692246
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Entity Type
Organization
Authorized Contact
DIANA M MANCUSO
President
334-793-4120
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: AL 4436)
Enumeration Date
2008-09-26
Last Update Date
2009-03-09
Business Address
DIANA M MANCUSO MD PA
4300 W MAIN ST SUITE 16
DOTHAN, AL 36305-1054
Phone number: 334-793-4120
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Mailing Address
DIANA M MANCUSO MD PA
4300 W MAIN ST SUITE 16
DOTHAN, AL 36305-1054
Phone number: 334-793-4120
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