Individual
MS. FAWN MICHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
7400 OLD MAIN HL, LOGAN, UT 84322-7400
(435) 797-3636
(435) 797-8032
Mailing address
7400 OLD MAIN HL, LOGAN, UT 84322-7400
(435) 797-3636
(435) 797-8032
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
6334257-4810
UT
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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