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1477600963
GREGORY DALE HAWTHORNE
EAST LANSING, MI
NPI
1477600963
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date
2007-01-05
Last Update Date
2007-07-08
Business Address
MR. GREGORY DALE HAWTHORNE ATC
JENISON FIELDHOUSE MICHIGAN STATE UNIVERSITY
EAST LANSING, MI 48823
Phone number: 517-355-1627
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Mailing Address
MR. GREGORY DALE HAWTHORNE ATC
4495 HERITAGE AVE APT B3
OKEMOS, MI 48864-3309
Phone number: 734-834-7862
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