Individual
TATUM R FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
345 HEALTHWEST DR, DOTHAN, AL 36303-2053
(334) 793-2663
(334) 836-1478
Mailing address
PO BOX 729, DOTHAN, AL 36302-0729
(334) 793-2663
(334) 836-1478
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1730
AL
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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