Individual
MR. JERRY WAYNE WAINWRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
18388 HARRY JONES RD N, SUMMERDALE, AL 36580-3485
(251) 367-4673
Mailing address
18388 HARRY JONES RD N, SUMMERDALE, AL 36580-3485
(251) 367-4673
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-037466
AL
Other
Enumeration date
02/04/2010
Last updated
02/04/2010
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