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Individual

MS. MARY BETH KATES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
520 HIGGINS RD, BENTONIA, MS 39040-9073
(205) 746-3113
Mailing address
520 HIGGINS RD, BENTONIA, MS 39040-9073
(205) 746-3113

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0074
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
029402501
NATABOC
01
AT0074
MISSISSIPPI STATE LICENSE
MS
Enumeration date
10/03/2006
Last updated
06/07/2016
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