AUSTYN LYNNELL BOULWARE

SOUTHFIELD, MI
NPI1326504994
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
(Licence: MI  B460084564641)
Enumeration Date2019-02-19
Last Update Date2019-02-19
Business Address
AUSTYN LYNNELL BOULWARE
23225 THORNCLIFFE ST
SOUTHFIELD, MI 48033-6559
Phone number: 586-917-2338
Mailing Address
AUSTYN LYNNELL BOULWARE
23225 THORNCLIFFE ST
SOUTHFIELD, MI 48033-6559
Phone number: 586-917-2338
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