Individual
JERRY GWIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(800) 874-9447
Mailing address
1401 CARSON RD, APT. 90, CENTER POINT, AL 35215-5916
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-062724
AL
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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