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Individual

MISS GRETCHEN E. BUSKIRK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
799 N HEWITT RD, YPSILANTI, MI 48197-1701
(734) 487-5183
Mailing address
799 N HEWITT RD, YPSILANTI, MI 48197-1701
(734) 487-5183

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002135
MI
2255A2300X
Athletic Trainer
AT 003271
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060402534
ATHLETIC TRAINER
01
2601002135
ATHLETIC TRAINER STATE LICENSURE
MI
01
AT 003271
ATHLETIC TRAINER LICENSURE
OH
Enumeration date
02/08/2007
Last updated
05/23/2019
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