Individual
CAMERON STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
4308 RICHARDSON DR NW, HUNTSVILLE, AL 35816-3528
(307) 763-1886
Mailing address
4308 RICHARDSON DR NW, HUNTSVILLE, AL 35816-3528
(307) 763-1886
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1951
AL
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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