Individual
MARK JEFFREY MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
15777 NORTHLINE RD, SUITE 102, SOUTHGATE, MI 48195-2385
(734) 246-8125
(734) 246-8113
Mailing address
15777 NORTHLINE RD, SUITE 102, SOUTHGATE, MI 48195-2385
(734) 246-8125
(734) 246-8113
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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