Individual
MRS. FARREN MONTANA OTWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LMT
Contact information
Practice address
300 TWINING ST BLDG 760, MAXWELL AFB, AL 36112-6027
(334) 953-5200
(334) 953-8607
Mailing address
300 TWINING ST BLDG 760, MAXWELL AFB, AL 36112-6027
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
5123
AL
225700000X
Massage Therapist
3847
AL
Other
Enumeration date
03/07/2024
Last updated
06/12/2024
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