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NPI 1548258338

NPI 1548258338 : STRAUM ERIK YORTON ATC : MOUNT PLEASANT, MI

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General NPI Number Information
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    NPI Number           |    1548258338
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    Entity Type          |    Individual 
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    Provider Name        |    STRAUM ERIK YORTON ATC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/06/2005
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    Last Update Date     |    06/18/2010
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Provider Practice Location Address
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    Address Line         |    CHIP FACILITY CENTRAL MICHIGAN UNIVERSITY
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    City                 |    MOUNT PLEASANT
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    State                |    MI
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    Zip                  |    48859-0001
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    Country              |    US
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    Telephone            |    989-774-7833
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    Fax                  |    989-774-2177
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Provider Business Mailing Address
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    Address Line         |    CHIP FACILITY CENTRAL MICHIGAN UNIVERSITY
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    City                 |    MOUNT PLEASANT
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    State                |    MI
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    Zip                  |    48859-0001
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    Country              |    US
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    Telephone            |    989-774-7833
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    Fax                  |    989-774-2177
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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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