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Individual

LAUREN A WILLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC, MAT

Contact information

Practice address
6649 VIBBERT AVE, FORT BENNING, GA 31905-4464
(251) 716-2109
Mailing address
522 LEE ROAD 613, SMITHS STATION, AL 36877-2004
(251) 716-2109

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT004188
GA

Other

Enumeration date
10/04/2022
Last updated
10/04/2022
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