Individual
DIVYA BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4371 NARROW LANE RD STE 100, MONTGOMERY, AL 36116-2975
(334) 613-3680
(334) 613-3685
Mailing address
4371 NARROW LANE RD STE 100, MONTGOMERY, AL 36116-2975
(334) 613-3680
(334) 613-3685
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
L.4102R
AL
Other
Enumeration date
02/26/2015
Last updated
02/26/2015
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