Individual
MR. LAWRENCE WAYNE WIECZOREK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
32 POST OAK LN, JACKSONS GAP, AL 36861-2545
(251) 769-1900
Mailing address
32 POST OAK LN, JACKSONS GAP, AL 36861-2545
(251) 769-1900
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-064713
AL
Other
Enumeration date
04/25/2006
Last updated
07/08/2007
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