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General NPI Number Information
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NPI Number | 1376053579
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Entity Type | Individual
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Provider Name | SHELBY ALYSSA HUTCHINS MBA, AT, ATC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 6518 SAND CREEK HWY
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City | SAND CREEK
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State | MI
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Zip | 49279-9703
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Country | US
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Telephone | 734-731-6045
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Fax |
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Provider Business Mailing Address
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Address Line | 1139 DIVISION ST
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City | ADRIAN
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State | MI
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Zip | 49221-4214
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Country | US
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Telephone |
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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 |
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License Number State |
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