Individual
MR. ODIS BRANDON OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
212 STONERIVER DR, BIRMINGHAM, AL 35211-4550
(205) 253-9225
Mailing address
212 STONERIVER DR, BIRMINGHAM, AL 35211-4550
(205) 253-9225
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1099421
AL
367500000X
Certified Registered Nurse Anesthetist
2290823
MA
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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