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Individual

MRS. SARA LYNN VIDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
9800 TURK RD, OTTAWA LAKE, MI 49267-8733
(734) 856-7048
Mailing address
9800 TURK RD, OTTAWA LAKE, MI 49267-8733
(734) 856-7048

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
07/31/2006
Last updated
07/08/2007
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