Individual
TADIE REPOLL PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1213 MARIETTA DR W, MOBILE, AL 36618-2343
(251) 656-5207
Mailing address
1213 MARIETTA DR W, MOBILE, AL 36618-2343
(251) 656-5207
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/26/2018
Last updated
07/26/2018
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