Individual
MR. JUSTIN ROBERT POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2505 US HIGHWAY 431, BOAZ, AL 35957-5908
(256) 593-8310
(256) 840-3647
Mailing address
800 EAST CARPENTER STREET, SPRINGFIELD, IL 62702
(217) 544-6464
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209016109
IL
Other
Enumeration date
03/20/2017
Last updated
08/15/2024
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