Individual
ANNA CHRISTINE POWELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC, LAT, CSCS
Contact information
Practice address
1145 HIGHWAY 42, PETAL, MS 39465-9740
(601) 544-0500
(601) 544-0505
Mailing address
31 KEYSTONE DR, PETAL, MS 39465-2524
(601) 545-3810
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0175
MS
Other
Enumeration date
04/04/2006
Last updated
07/08/2007
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