Individual
MICHEAL RAY GADDIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., A.T.,C
Contact information
Practice address
1906 COLLEGE HEIGHTS BLVD, BOWLING GREEN, KY 42101-1000
(270) 745-5317
Mailing address
592 FARMER LN, BOWLING GREEN, KY 42104-8546
(270) 745-5317
(270) 745-2412
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT218
KY
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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