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Individual

AUTUMN ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AT, ATC

Contact information

Practice address
21600 NOVI RD, NOVI, MI 48375-5605
(248) 679-5396
Mailing address
5678 DRAKE HOLLOW DR W, WEST BLOOMFIELD, MI 48322-1274
(313) 282-7013

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002564
MI

Other

Enumeration date
07/12/2021
Last updated
07/12/2021
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