Individual
MS. EBONNIE CAMILLE WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.C
Contact information
Practice address
24901 NORTHWESTERN HWY, SOUTHFIELD, MI 48075-2203
(248) 358-3001
Mailing address
18400 LAUDER ST, DETROIT, MI 48235-2737
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
010702102
NE
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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