Individual
ROYAL BETTIS MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 GAUTIER ST, TUSKEGEE, AL 36083-2645
(334) 226-1454
Mailing address
PO BOX 830208, TUSKEGEE, AL 36083-0208
(334) 724-9856
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-169700
AL
Other
Enumeration date
06/25/2020
Last updated
07/06/2020
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