Individual
MR. MICHAEL HOWARD BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
210 SPORTS DR, BIG RAPIDS, MI 49307-2741
(231) 591-2872
Mailing address
210 SPORTS DR, BIG RAPIDS, MI 49307-2741
(231) 591-2872
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
MI
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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