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General NPI Number Information
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NPI Number | 1417612458
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Entity Type | Organization
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Legal Business Name | INNOVATIVE TRAINING SOLUTIONS
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Dates
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Enumeration Date | 11/04/2021
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 13757 EUREKA RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-1352
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Country | US
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Telephone | 734-258-8705
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Fax |
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Provider Business Mailing Address
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Address Line | 6486 N GULLEY RD
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-2033
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Country | US
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Telephone | 313-363-9121
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANNA MARIA NAPOLITANO
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Credential | ATC
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Telephone | 313-363-9121
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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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