Individual
JUSTIN EDWARD CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AT,ATC, CSCS
Contact information
Practice address
8500 BURLINGAME AVE SW, BYRON CENTER, MI 49315-6941
(161) 687-8600
Mailing address
1904 HEATH RD, HASTINGS, MI 49058-9721
(616) 443-6692
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001120
MI
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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