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MISS MOLLIE AMENDOLA CLAY ATC
Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1467939009
Individual Registrant:MISS MOLLIE AMENDOLA CLAY ATC
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
UWA STATION 14 LIVINGSTON, AL 35470 US
Tel: 205-652-3714 Fax: --
Tel: 205-652-3714 Fax: --
Contact information for business:
101 NE ADDISON STREET LIVINGSTON, AL 35470 US
Tel: 770-365-5873 Fax: --
Tel: 770-365-5873 Fax: --
Registration Information:
NPI: 1467939009
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 2255A2300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist Athletic Trainer |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
