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1770693640
SCOTT R. WYSOWSKI
FORT WORTH, TX
NPI
1770693640
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA04750)
Enumeration Date
2006-08-30
Last Update Date
2022-01-04
Business Address
SCOTT R. WYSOWSKI PA-C
4501 HERITAGE TRACE PKWY STE 101
FORT WORTH, TX 76244-8941
Phone number: 817-481-2121
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Mailing Address
SCOTT R. WYSOWSKI PA-C
2535 IRA E WOODS AVE
GRAPEVINE, TX 76051-3930
Phone number: 817-481-2121
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