Individual
EBONY SHANTELL GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
330 LEVINE RD, ODENVILLE, AL 35120-3607
(205) 760-0752
Mailing address
330 LEVINE RD, ODENVILLE, AL 35120-3607
(205) 760-0752
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
—
AL
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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