Individual
BRENT HAVERSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1717 6TH AVE S, BIRMINGHAM, AL 35233-1801
(800) 822-8816
Mailing address
1717 6TH AVE S, BIRMINGHAM, AL 35233-1801
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
335
AL
Other
Enumeration date
05/20/2017
Last updated
06/04/2025
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