Individual
MICHELLE RAE WARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2800 W GORE BLVD, LAWTON, OK 73505-6320
(580) 581-2402
Mailing address
2800 W GORE BLVD, LAWTON, OK 73505-6320
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
421
OK
225700000X
Massage Therapist
—
OK
Other
Enumeration date
03/23/2012
Last updated
03/23/2012
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