Individual
AMANAD DIVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
99 MAGNOLIA SOUTH, LINCOLN, AL 35096
(205) 763-7759
(205) 763-2131
Mailing address
1103 PINEVIEW AVE, GLENCOE, AL 35905-7204
(256) 492-9193
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14604
AL
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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