Individual
SHINGO MATSUBARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
261 MACK AVE, DETROIT, MI 48201-2417
(313) 745-9745
Mailing address
22555 CRANBROOKE DR, NOVI, MI 48375-4503
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000672
MI
Other
Enumeration date
12/23/2017
Last updated
12/23/2017
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