Individual
MICHAEL JARED WHEATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
UWA STATION 14, LIVINGSTON, AL 35470
(270) 699-1589
Mailing address
3000 FREDERICA ST, OWENSBORO, KY 42301-6057
(270) 699-1589
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/13/2017
Last updated
09/08/2020
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