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General NPI Number Information
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NPI Number | 1740407790
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Entity Type | Individual
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Provider Name | SHAYE ANALEE SMALLWOOD ATC
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5476 CALDWELL MILL RD
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City | BIRMINGHAM
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State | AL
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Zip | 35242-4520
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Country | US
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Telephone | 205-682-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 229 REACH WAY
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City | BIRMINGHAM
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State | AL
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Zip | 35242-8617
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Country | US
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Telephone | 205-368-0155
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 641
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License Number State | AL
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