Individual
JULIE LYNN GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, AT
Contact information
Practice address
PORTAGE NORTHERN HIGH SCHOOL, 1000 IDAHO AVE, PORTAGE, MI 49024
(269) 323-5400
Mailing address
4711 DOVER HILLS DR APT 205, 4711 DOVER HILLS DR APT 205, KALAMAZOO, MI 49009
(703) 231-6233
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001698
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000023797
MICHIGAN STATE LICENSURE, ATHLETIC TRAINER
MI
01
—
2000023797
BOARD OF CERTIFICAITON INC, ATHLETIC TRAINER
—
Enumeration date
03/20/2018
Last updated
03/20/2018
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