Individual
RYAN P. KLAWON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AT, ATC
Contact information
Practice address
CHIP FACILITY, CENTRAL MICHIGAN UNIVERSITY, MOUNT PLEASANT, MI 48859-0001
(989) 774-1663
Mailing address
CHIP FACILITY, CENTRAL MICHIGAN UNIVERSITY, MOUNT PLEASANT, MI 48859-0001
(989) 774-1663
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000284
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020802067
BOARD OF CERTIFICATION (ATHLETIC TRAINER)
—
01
—
2601000284
ATHLETIC TRAINER LICENSE
MI
Enumeration date
01/05/2012
Last updated
04/23/2014
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