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Individual

MR. JOHN WISMER MCDOUGALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
A.T.,C

Contact information

Practice address
550 MUNSON AVE, TRAVERSE CITY, MI 49686-3580
(231) 935-8653
(231) 935-8609
Mailing address
3633 APOLLO DR, TRAVERSE CITY, MI 49684-8711
(231) 935-8653
(231) 935-8609

Taxonomy

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

Other

Enumeration date
04/03/2007
Last updated
07/08/2007
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