Individual
RAVEN LESHEA STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1524 RAYBURN AVE, GUNTERSVILLE, AL 35976-1720
(256) 558-2516
Mailing address
1524 RAYBURN AVE, GUNTERSVILLE, AL 35976-1720
(256) 558-2516
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S12647
AL
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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