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1629474648
TIMOTHY AARON STANLEY FRACASSI
SOUTHFIELD, MI
NPI
1629474648
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MI 2601000720)
Enumeration Date
2014-11-18
Last Update Date
2014-11-18
Business Address
-- TIMOTHY AARON STANLEY FRACASSI LAT
28650 LAHSER RD
SOUTHFIELD, MI 48034-2020
Phone number: 248-789-1068
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Mailing Address
-- TIMOTHY AARON STANLEY FRACASSI LAT
16935 W 12 MILE RD
SOUTHFIELD, MI 48076-2101
Phone number: 248-789-1068
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