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General NPI Number Information
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NPI Number | 1033181714
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Entity Type | Individual
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Provider Name | MICHELLE SUSAN VARNELL ATC
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Gender | Female
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4710 N 5TH ST
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City | PHOENIX
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State | AZ
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Zip | 85012-1738
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Country | US
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Telephone | 602-240-3119
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 E BASELINE RD #1433
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City | GILBERT
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State | AZ
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Zip | 85234-9101
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Country | US
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Telephone | 602-463-9605
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0543
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License Number State | AZ
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