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Individual

TREVOR WALTERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM. D.

Contact information

Practice address
201 LAKESHORE PKWY, BIRMINGHAM, AL 35209-7105
(205) 941-0376
(205) 941-0934
Mailing address
201 LAKESHORE PKWY, BIRMINGHAM, AL 35209-7105
(205) 941-0376
(205) 941-0934

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15731
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15731
CONTROLLED SUBSTANCE REGISTRATION NUMBER, ALABAMA STATE BOARD OF PHARMACY
AL
Enumeration date
12/01/2015
Last updated
12/01/2015
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