NPI | 1245261841 |
---|---|
Former Name | MICHELLE L LEVREAULT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: RI AT00203) |
Enumeration Date | 2006-07-05 |
Last Update Date | 2018-03-02 |