Individual
MR. PHILIP JAY CRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.,C.
Contact information
Practice address
6500 25 MILE RD, SHELBY TOWNSHIP, MI 48316-1703
(586) 797-1300
(586) 797-1301
Mailing address
71843 EAST POND CREEK, BRUCE TWP, MI 48065
(586) 331-7009
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
L488935
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/05/2007
Last updated
03/16/2018
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