Individual
MOLLY PERALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
113 RIVIERA DR, MICHIGAN CITY, IN 46360-6800
(219) 561-4173
Mailing address
113 RIVIERA DR, MICHIGAN CITY, IN 46360-6800
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT6728
TX
Other
Enumeration date
06/01/2017
Last updated
06/01/2017
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