Individual
MR. MICHAEL TYRONE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S. A.T.C.
Contact information
Practice address
101 MARIETTA ST NW, ATLANTA, GA 30303-2720
(404) 246-9770
Mailing address
152 FULTON WAY SE, ATLANTA, GA 30312-2916
(404) 246-9770
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001037
GA
Other
Enumeration date
04/06/2006
Last updated
07/08/2015
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