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Individual

MRS. AMY MICHELLE MCKOUEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
3100 CROSS CREEK PKWY, AUBURN HILLS, MI 48326-2774
(248) 377-8000
Mailing address
15121 WESTERN VALLEY DR, HOLLY, MI 48442-1912
(248) 634-8636

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22
ATC
MI
Enumeration date
05/25/2007
Last updated
07/08/2007
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