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1881167047
HOLLY SUSAN BOUTWELL
MONTGOMERY, AL
NPI
1881167047
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163WN0002X Registered Nurse Neonatal Intensive Care
(Licence: AL 1-156485)
Enumeration Date
2019-01-09
Last Update Date
2019-01-09
Business Address
HOLLY SUSAN BOUTWELL RN
2105 E SOUTH BLVD
MONTGOMERY, AL 36116-2409
Phone number: 334-286-2823
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Mailing Address
HOLLY SUSAN BOUTWELL RN
1535 COUNTY ROAD 37
FITZPATRICK, AL 36029-2909
Phone number: 214-995-7979
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