Individual
PATTY STALLWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CEO
Contact information
Practice address
273 AZALEA RD BLDG 1, SUITE 100, MOBILE, AL 36609-1970
(251) 607-6327
Mailing address
273 AZALEA RD BLDG 1, SUITE 100, MOBILE, AL 36609-1970
(251) 607-6327
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
347C00000X
AL
347C00000X
Private Vehicle
347C00000X
AL
347C00000X
Private Vehicle
—
AL
374U00000X
Home Health Aide
Primary
374U00000X
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326069964
VETERANS HOMEBOUND SERVICES
—
01
—
1679654966
VETERANS HOMEBOUND SERVICES
—
Enumeration date
04/25/2016
Last updated
06/20/2016
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