Individual
MR. JERRY DONALD WHITESIDE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
3120 BOB WALLACE AVE SW, HUNTSVILLE, AL 35805-4004
(256) 533-5058
(256) 533-6967
Mailing address
3120 BOB WALLACE AVE SW, HUNTSVILLE, AL 35805-4004
(256) 533-5058
(256) 533-6967
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12196
AL
Other
Enumeration date
09/16/2011
Last updated
09/16/2011
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