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Individual

MR. JACK PHIL KRYSTYN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
184 CARAVAN LN, KINSEY, AL 36303-7694
(334) 678-8268
Mailing address
184 CARAVAN LN, KINSEY, AL 36303-7694
(334) 678-8268

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
1-03341
AL

Other

Enumeration date
10/23/2006
Last updated
07/08/2007
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