Individual
ADAM THIESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT, ATC
Contact information
Practice address
3950 HOLLYWOOD RD, SUITE 140, SAINT JOSEPH, MI 49085-9159
(269) 556-7150
Mailing address
3001 LAKESHORE DR, APT 344, SAINT JOSEPH, MI 49085-2382
(517) 990-5490
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001631
MI
Other
Enumeration date
04/12/2016
Last updated
06/17/2016
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