Individual
TODD KILLINGSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
4300 W MAIN ST, SUITE 14, DOTHAN, AL 36305-1054
(334) 793-2663
(334) 836-2247
Mailing address
PO BOX 729, DOTHAN, AL 36302-0729
(334) 793-2663
(334) 836-2247
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
354
AL
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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