WAYNE JUWAN DARISAW

TIFTON, GA
NPI1619530276
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: GA  100941)
Enumeration Date2019-04-19
Last Update Date2024-08-28
Business Address
WAYNE JUWAN DARISAW
901 18TH ST E
TIFTON, GA 31794-3648
Phone number: 229-382-7120
Mailing Address
WAYNE JUWAN DARISAW
PO BOX 2650
TIFTON, GA 31793-2650
Phone number:
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