DAVID FORMWALT

MOBILE, AL
NPI1164591541
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: AL  1104)
Enumeration Date2006-11-07
Last Update Date2007-07-09
Business Address
-- DAVID FORMWALT Psy D
7305 COTTAGE HILL ROAD
MOBILE, AL 36695
Phone number: 251-776-1217
Mailing Address
-- DAVID FORMWALT Psy D
POB 91276 DAVID FORMWALT PSY D LLC
MOBILE, AL 36691
Phone number: 251-776-1217
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