Individual
BRYAN KEITH BAINES SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, EMT
Contact information
Practice address
4333 JOHN R RD, TROY, MI 48085-3681
(248) 823-2981
Mailing address
4266 ANGELINE DR, STERLING HEIGHTS, MI 48310-5002
(248) 765-2487
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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