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Individual

WIL OWENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1201 11TH AVE S # 516, BIRMINGHAM, AL 35205-3423
(205) 934-7053
Mailing address
670 JOHNNYS CV, LEEDS, AL 35094-6609

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86297930
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86297930
ACADEMY OF NUTRITION AND DIETETICS
AL
Enumeration date
09/08/2022
Last updated
09/08/2022
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