Individual
MR. DANIEL RILEY BOALCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 LAKESHORE DR, BIRMINGHAM, AL 35229-0001
(205) 726-4772
Mailing address
800 LAKESHORE DR, BIRMINGHAM, AL 35229-0001
(205) 726-4772
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S10586
AL
Other
Enumeration date
05/08/2013
Last updated
05/08/2013
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