Individual
MS. DONNA SWILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14528 INDIAN TRAILS CIR, DIBERVILLE, MS 39540-8607
(228) 669-8018
Mailing address
14528 INDIAN TRAILS CIR, DIBERVILLE, MS 39540-8607
(228) 669-8018
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
MSAT0023
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MS0023AT
CERTIFIEDL ATHLETIC TRAINER
MS
Enumeration date
05/11/2017
Last updated
05/11/2017
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