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Individual

JAMES DEVANE ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RRT

Contact information

Practice address
101 W COVINGTON AVE, SUITE B, OPP, AL 36467-2032
(334) 493-7081
(334) 493-1525
Mailing address
PO BOX 375, OPP, AL 36467-0375
(334) 493-7081
(334) 493-1525

Taxonomy

Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
684
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009809650
AL
01
1162690001
PTAN
AL
01
51032703
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/06/2016
Last updated
06/06/2016
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