Individual
IBRAHEEM MUTAHR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
7940 CREEK BEND DR, YPSILANTI, MI 48197-6204
(734) 383-2146
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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