Individual
MR. ANTHONY ANDREW DIVALENTIN IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D., L.D.
Contact information
Practice address
6920 BOILING SPRINGS RD, OHATCHEE, AL 36271-6341
(256) 892-6779
Mailing address
6920 BOILING SPRINGS RD, OHATCHEE, AL 36271-6341
(256) 892-6779
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1527
AL
Other
Enumeration date
04/01/2008
Last updated
04/01/2008
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