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General NPI Number Information
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NPI Number | 1710526462
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Entity Type | Individual
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Provider Name | STEVEN CAVINS ATC
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Gender | Male
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Dates
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Enumeration Date | 12/29/2019
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Last Update Date | 12/29/2019
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Provider Practice Location Address
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Address Line | 35765 NORTHLINE RD
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City | ROMULUS
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State | MI
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Zip | 48174-3647
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Country | US
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Telephone | 734-941-2126
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Fax | 734-941-2283
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Provider Business Mailing Address
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Address Line | 4151 SWAN RIDGE LN
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City | NEWPORT
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State | MI
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Zip | 48166-6603
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Country | US
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Telephone | 419-350-0278
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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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