| NPI | 1508370479 |
|---|---|
| Former Name | COURTNEY LEE MCCORMICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MI 2601001449) |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-11-29 |