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Individual

MISS AMY MICHELLE WHITLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
4381 S EASON BLVD, TUPELO, MS 38801-6583
(662) 377-7215
Mailing address
114 MONUMENT DR # B, TUPELO, MS 38801-4404

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 0419
MS

Other

Enumeration date
06/06/2007
Last updated
07/08/2007
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