Individual
ALLISON WHITESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
28000 DEQUINDRE RD, WARREN, MI 48092-2468
(740) 418-3089
Mailing address
8500 FLETCHER RD, GRAND BLANC, MI 48439-8908
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001028
MI
Other
Enumeration date
08/23/2012
Last updated
08/23/2012
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