Individual
ANNAIL REESE FORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED HAIR LOSS
Contact information
Practice address
3009B MCGEHEE RD, MONTGOMERY, AL 36111-2202
(334) 280-3930
Mailing address
3009B MCGEHEE RD, MONTGOMERY, AL 36111-2202
(334) 280-3930
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
59208
AL
174H00000X
Health Educator
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012375683899003082
UNITEDHEALTHCARE
—
Enumeration date
11/18/2015
Last updated
11/18/2015
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