Anthony Andrew Divalentin IV, R.D., L.D.
Dietitian, Registered in Ohatchee, AL. Individual provider (NPI-1).
NPI number1245402007
StatusActive
Last updated in NPPESApr 1, 2008
Details
- NPI
- 1245402007
- Entity type
- Individual (NPI-1)
- Name
- Mr. Anthony Andrew Divalentin IV
- Credential
- R.D., L.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 1, 2008
- Last updated
- Apr 1, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 1527 | AL | Yes |
Practice location
6920 Boiling Springs RdOhatchee, AL 36271-6341
Phone 256-892-6779
Mailing address
6920 Boiling Springs RdOhatchee, AL 36271-6341
Phone 256-892-6779
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