Individual
CLAYTON SIBLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
287 MS-6, BATESVILLE, MS 38606
(662) 578-7799
Mailing address
61 SULLIVANT RD, BATESVILLE, MS 38606-9548
(166) 293-4425
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-0869
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000028584
BOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER
—
01
—
AT-0869
MISSISSIPPI LICENSE FOR ATHLETIC TRAINING
MS
Enumeration date
01/07/2021
Last updated
01/07/2021
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