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1740856848
DERRICK JEROME SHOWALTER
PRINCETON, WV
NPI
1740856848
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172A00000X Driver
(Licence: WV f341538)
Enumeration Date
2021-05-28
Last Update Date
2021-05-28
Business Address
DERRICK JEROME SHOWALTER
1122 MERCER ST
PRINCETON, WV 24740-3030
Phone number: 304-800-0544
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Mailing Address
DERRICK JEROME SHOWALTER
1122 MERCER ST
PRINCETON, WV 24740-3030
Phone number: 304-800-0544
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