Individual
MRS. MICHELLE RENEE DEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
105 FIR DR, COLLEGEVILLE, PA 19426-3916
(610) 888-9406
Mailing address
105 FIR DR, COLLEGEVILLE, PA 19426-3916
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003585
PA
Other
Enumeration date
08/30/2007
Last updated
08/30/2007
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