Individual
MR. MICHAEL STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
UWA STATION #14, LIVINGSTON, AL 35470-0000
(217) 932-3001
Mailing address
STATION #14, UWA, LIVINGSTON, AL 35470-0000
(217) 932-3001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001906A
IN
Other
Enumeration date
07/23/2013
Last updated
07/23/2013
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