Individual
COREY SKELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
1201 11TH AVE S, BIRMINGHAM, AL 35205-3423
(205) 930-8339
Mailing address
PO BOX 20173, TUSCALOOSA, AL 35402-0173
(205) 331-2676
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2433
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PPA871958952
BLUECROSSBLUESHIELD
AL
Enumeration date
05/16/2018
Last updated
08/06/2024
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