Individual
MR. GERRY LEE WADDLE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
209 RIDGE ROAD, DAVIDSON, NC 28035
(704) 894-2806
(704) 894-2802
Mailing address
PO BOX 1747, DAVIDSON, NC 28036-1747
(704) 582-1947
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0817
NC
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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