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Individual

MISS MARNIE LARISSA HAWES I

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
11300 NE 2ND AVE, MIAMI SHORES, FL 33161-6628
(305) 899-3000
Mailing address
2623 CANAL DR, WOLVERINE LAKE, MI 48390-2123

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
08/22/2016
Last updated
03/17/2018
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