Individual
MRS. ERIN KAY TABACZKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3737 PRATT LAKE AVE SE, LOWELL, MI 49331-9307
(616) 897-0861
Mailing address
3737 PRATT LAKE AVE SE, LOWELL, MI 49331-9307
(616) 897-0861
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
965401
MI
Other
Enumeration date
04/07/2007
Last updated
07/08/2007
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