Healthcare Provider Details

I. General information

NPI: 1285661082
Provider Name (Legal Business Name): JAMES MICHAEL RANKIN PH.D., ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7784 KENSINGTON RD
LAMBERTVILLE MI
48144-8627
US

IV. Provider business mailing address

7784 KENSINGTON RD
LAMBERTVILLE MI
48144-8627
US

V. Phone/Fax

Practice location:
  • Phone: 734-856-4693
  • Fax: 419-530-2477
Mailing address:
  • Phone: 734-856-4693
  • Fax: 419-530-2477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT000127
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: