Individual
ELLYNN JOANN ROLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
219 INDUSTRIAL PARK ST, GORDO, AL 35466-2068
(205) 364-1003
Mailing address
800 ENERGY CENTER BLVD APT 3414, NORTHPORT, AL 35473-2736
(309) 264-5787
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2163
AL
Other
Enumeration date
01/07/2020
Last updated
01/07/2020
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