Individual
MR. CORY KENNETH VANAMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3 S WARWICK RD, GREENVILLE, SC 29617-6167
(906) 286-0047
Mailing address
9524W STATE HIGHWAY M149, MANISTIQUE, MI 49854
(906) 286-0047
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
SC
Other
Enumeration date
07/14/2014
Last updated
09/22/2014
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