Individual
MIKAELA CARRUTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7525 METROPOLITAN DR STE 306, SAN DIEGO, CA 92108-4404
(844) 316-7979
(866) 813-1235
Mailing address
3941 BRENTON CT SE, GRAND RAPIDS, MI 49508-8948
(989) 574-7898
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002546
MI
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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