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1912570607
JERRY PAUL WISDOM
DOTHAN, AL
NPI
1912570607
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AL 1-152894)
Enumeration Date
2021-07-20
Last Update Date
2021-07-20
Business Address
JERRY PAUL WISDOM CRNP
1450 ROSS CLARK CIR STE 400
DOTHAN, AL 36301-4770
Phone number: 334-305-0400
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Mailing Address
JERRY PAUL WISDOM CRNP
1450 ROSS CLARK CIR STE 400
DOTHAN, AL 36301-4770
Phone number: 334-305-0400
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