Individual
KENNETH J BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
STUDENT AT
Contact information
Practice address
11275 HEMLOCK LN, GRAND HAVEN, MI 49417-8460
(616) 402-5386
Mailing address
11275 HEMLOCK LN, GRAND HAVEN, MI 49417-8460
(616) 402-5386
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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