Individual
THOMAS WISSERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
614 S COURT ST, FLORENCE, AL 35630-6111
(615) 567-6726
Mailing address
PO BOX 682427, FRANKLIN, TN 37068-2427
(615) 567-6726
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2672
AL
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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