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Individual

DEVON ROSS GILDEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MAT, AT, ATC

Contact information

Practice address
333 S CLARK ST, HOPKINS, MI 49328-9501
(269) 793-7616
Mailing address
547 CHERRY ST SE APT 1N, GRAND RAPIDS, MI 49503-4749
(269) 903-1794

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002637
MI

Other

Enumeration date
10/12/2021
Last updated
10/12/2021
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