Individual
MICHAEL WAYNE HILLIARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
649 17TH ST S, MOORHEAD, MN 56560
(360) 751-9904
Mailing address
649 17TH ST S, MOORHEAD, MN 56560
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2826
MN
Other
Enumeration date
12/15/2017
Last updated
03/14/2018
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