Individual
MISS HAYLEY ANN WIDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSK, LAT, ATC
Contact information
Practice address
410 BAYTREE RD APT 30F, VALDOSTA, GA 31602-3235
(419) 677-3848
Mailing address
1 S HAMILTON ST APT 3, MONROEVILLE, OH 44847-9409
(419) 677-3848
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003663
GA
2255A2300X
Athletic Trainer
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Other
Enumeration date
09/12/2017
Last updated
12/12/2023
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