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1023234648
CHARLES EDWARD FORTENBERRY
DECATUR, AL
NPI
1023234648
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: AL 1-049601)
Enumeration Date
2007-04-18
Last Update Date
2007-10-22
Business Address
-- CHARLES EDWARD FORTENBERRY R.N.
1103 16TH AVE SE
DECATUR, AL 35601-3595
Phone number: 256-350-0362
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Mailing Address
-- CHARLES EDWARD FORTENBERRY R.N.
1103 16TH AVE SE
DECATUR, AL 35601-3595
Phone number:
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