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MISS MOLLIE AMENDOLA CLAY ATC

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1467939009

Individual Registrant:
MISS MOLLIE AMENDOLA CLAY ATC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
UWA STATION 14  LIVINGSTON, AL 35470 US
Tel: 205-652-3714  Fax: --

Contact information for business:
101 NE ADDISON STREET  LIVINGSTON, AL 35470 US
Tel: 770-365-5873  Fax: --

Registration Information:
NPI: 1467939009
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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