Individual
MICHAEL R LEROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
5747 MEMORIAL GYM, ORONO, ME 04469
(603) 581-3053
Mailing address
5747 MEMORIAL GYM, ORONO, ME 04469-5747
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT602
ME
Other
Enumeration date
06/08/2017
Last updated
06/08/2017
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