Individual
WENDI TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 W MAIN ST STE 21, DOTHAN, AL 36305-1058
(334) 944-7070
(334) 615-8463
Mailing address
4300 W MAIN ST STE 21, DOTHAN, AL 36305-1058
(334) 944-7070
(334) 615-8463
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-098098
AL
363L00000X
Nurse Practitioner
Primary
1-098098
AL
Other
Enumeration date
12/16/2013
Last updated
01/07/2014
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