Individual
AMANDA MARIE ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
201 W MAIN ST, BLUE MOUNTAIN, MS 38610-9220
(662) 685-4771
Mailing address
710 CITY AVE N, RIPLEY, MS 38663-1615
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1100
TN
2255A2300X
Athletic Trainer
Primary
AT0417
MS
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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