Individual
MR. EDMESTON ADOLPHUS WOODLEY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
118 COLLEGE DR # 5017, HATTIESBURG, MS 39406-0001
(601) 266-6666
Mailing address
309 LAKE AVE, PUEBLO, CO 81004-2329
(719) 924-0168
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0426
MS
Other
Enumeration date
05/30/2007
Last updated
07/08/2007
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