Individual
KYLE SOUTHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 LAKESHORE DR, BIRMINGHAM, AL 35229-0001
(205) 726-4715
Mailing address
800 LAKESHORE DR, BIRMINGHAM, AL 35229-0001
(205) 726-4715
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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