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1770830960
DEWAYNE CARL HAVERSTICK
FORT RUCKER, AL
NPI
1770830960
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
146L00000X Emergency Medical Technician, Paramedic
(Licence: AL 0800200)
Enumeration Date
2012-08-07
Last Update Date
2012-08-07
Business Address
-- DEWAYNE CARL HAVERSTICK NREMTP
453 SOUTH NOVACEL DR
FORT RUCKER, AL 36362
Phone number: 251-518-9110
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Mailing Address
-- DEWAYNE CARL HAVERSTICK NREMTP
104 S SPRINGVIEW DR
ENTERPRISE, AL 36330-5060
Phone number: 251-518-9110
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