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1518168236
EDMESTON ADOLPHUS WOODLEY
HATTIESBURG, MS
NPI
1518168236
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MS AT0426)
Enumeration Date
2007-05-30
Last Update Date
2007-07-08
Business Address
Mr. EDMESTON ADOLPHUS WOODLEY ATC, LAT
118 COLLEGE DR # 5017
HATTIESBURG, MS 39406-0001
Phone number: 601-266-6666
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Mailing Address
Mr. EDMESTON ADOLPHUS WOODLEY ATC, LAT
309 LAKE AVE
PUEBLO, CO 81004-2329
Phone number: 719-924-0168
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