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Individual
DR. JERRY STANLEY WAKE
Active
Individual
DR. JERRY STANLEY WAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5790T
CA
152WC0802X
Corneal and Contact Management Optometrist
5790T
CA
Other
Enumeration date
03/21/2007
Last updated
05/02/2014
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