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General NPI Number Information
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NPI Number | 1447762067
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Entity Type | Individual
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Provider Name | SARAH ELISABETH WILHELM AT, ATC
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Gender | Female
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Dates
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Enumeration Date | 11/05/2017
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Last Update Date | 11/05/2017
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Provider Practice Location Address
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Address Line | 3483 SPRING ARBOR RD
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City | JACKSON
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State | MI
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Zip | 49203-3637
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Country | US
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Telephone | 517-787-0630
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Fax | 517-787-1066
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Provider Business Mailing Address
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Address Line | 500 S ALPINE LAKE DR APT E
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City | JACKSON
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State | MI
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Zip | 49203-6321
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Country | US
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Telephone | 616-894-5557
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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 | 2601001033
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License Number State | MI
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