JERRY DEWAYNE WILSON

TUCKER, GA
NPI1619153210
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence: GA  003052)
Enumeration Date2008-01-14
Last Update Date2010-12-06
Business Address
JERRY DEWAYNE WILSON PA-C
4500 HUGH HOWELL RD SUITE
TUCKER, GA 30084-4723
Phone number: 678-632-4003
Mailing Address
JERRY DEWAYNE WILSON PA-C
PO BOX 360550
DECATUR, GA 30036-0550
Phone number: 678-632-4003
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