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Individual

MR. BRETT TYLER DEVEREAUX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
4000 WHITING DR, MIDLAND, MI 48640-6634
(989) 837-5894
(989) 837-4813
Mailing address
414 N SAGINAW RD, MIDLAND, MI 48640-3395
(517) 936-9239

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
L480722
MI

Other

Enumeration date
12/04/2014
Last updated
12/04/2014
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