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General NPI Number Information
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NPI Number | 1760525802
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Entity Type | Individual
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Provider Name | DAVID PHILIP CARRIER M.A., ATC
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Gender | Male
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | ATHLETIC DEPT. MICHIGAN STATE UNIVERSITY JENISON FIELDHOUSE
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City | E. LANSING
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State | MI
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Zip | 48824
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Country | US
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Telephone | 517-353-4564
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Fax | 517-432-1879
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Provider Business Mailing Address
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Address Line | 5937 VILLAGE DR
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City | HASLETT
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State | MI
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Zip | 48840-9503
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Country | US
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Telephone | 517-339-3743
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Fax | 517-432-1879
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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 | MI
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