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1356065270
LAUREN A WILLIE
FORT BENNING, GA
NPI
1356065270
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: GA AT004188)
Enumeration Date
2022-10-04
Last Update Date
2022-10-04
Business Address
LAUREN A WILLIE LAT, ATC, MAT
6649 VIBBERT AVE
FORT BENNING, GA 31905-4464
Phone number: 251-716-2109
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Mailing Address
LAUREN A WILLIE LAT, ATC, MAT
522 LEE ROAD 613
SMITHS STATION, AL 36877-2004
Phone number: 251-716-2109
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