Individual
GLENDA PEACOCK DERAMUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NBC HIS
Contact information
Practice address
2809 CHESTNUT ST, MONTGOMERY, AL 36107-3007
(334) 262-7553
(334) 261-3132
Mailing address
2809 CHESTNUT ST, MONTGOMERY, AL 36107-3007
(334) 262-7553
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
11284
AL
Other
Enumeration date
11/06/2008
Last updated
11/06/2008
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