Individual
JERRY WAYNE WHARTON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(276) 207-3108
Mailing address
3145 S ATLANTIC AVE APT 1203, DAYTONA BEACH, FL 32118-6274
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9117163
FL
Other
Enumeration date
05/26/2022
Last updated
03/02/2023
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