Individual
JAQUEL PERDUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1055 PRINCETON PARK, MONTEVALLO, AL 35115-8913
(205) 266-1403
Mailing address
1055 PRINCETON PARK, MONTEVALLO, AL 35115-8913
(205) 266-1403
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
46-4120981
AL
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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