Individual
MRS. CARLY RENAE MAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
100 W MAIN ST, SPRINGFIELD, OH 45502-1312
(937) 521-3900
Mailing address
128 E MAIN ST STE 3B, SPRINGFIELD, OH 45502-1367
(937) 408-0238
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004951
OH
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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