Individual
MS. MANDY MARIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
104 CHRYSTAL PLAZA DR, NEW ALBANY, MS 38652-3198
(662) 534-4445
(662) 534-9449
Mailing address
PO BOX 637, NEW ALBANY, MS 38652-0637
(662) 296-4808
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATO336
MS
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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